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Does the Affordable Care Act Cover Dental for Kids?

As the Affordable Care Act rolls out more information each day regarding its coverage, the public is learning more and more about what it does and doesn’t cover. Some of the latest news are aiming at disputing Pediatric Dental Care Insurance.

Dental Insurance for Kids

Pediatric Dental Insurance was included in the Affordable Care Act as one of the 10 “essential health benefits” the new health insurance plans are to include starting in 2014. When looking at the type of coverage the Pediatric Dental plans, they must include basic services such as preventative care of teeth cleaning and X-rays and fillings.

Many children will be covered insurance wise with dental care through Medicaid, some health insurance exchanges, and through employer-sponsored insurance.

Dental Plans Separate from Health Plans

Within the Affordable Care Act there is a glitch that is stopping the option of many children from having any dental care insurance. The law in itself requires insurance companies to offer pediatric dental care, but unless it is offered exclusively in a bundle package with healthcare, parents are not obligated to purchase the insurance. What is happening is that many insurance companies have decided to not offer it together with the health plan and it is now found as an alternative plan, making it unenforceable under the Affordable Care Act leaving millions of children without pediatric dental care.

Obamacare for Kids

Pediatric Dental Insurance not Affordable Under the Affordable Care Act

Many families qualify to receive tax credit for the Health Insurance Plan, but are finding out that pediatric care, unless it is bundled with the health insurance, it is not covered under the tax credit. These families are receiving tax credit for their health insurance because they cannot afford the full payment. This means that they cannot afford to add any pediatric dental care to cover any of their children’s dental care needs. This leaving out millions of children without dental care.

Dental Care for Children is Essential

When considering pediatric care we are not looking at some kind of optional sickness that can affect children. Dental decay is very much a reality among children and is cause for serious illness produced from such. It is the most common childhood disease.

Dental Care is Part of Healthcare

Pediatric dental healthcare should not be made separate under the Affordable Care Act. All health insurance should be made to bundle this care for children making it truly affordable with the tax subsidy. If the government is truly looking into providing healthcare for children they should not leave out pediatric dental care as it is the most common childhood disease. Many company are using this separation of dental insurance plan loophole to not cover children dental healthcareand leaving them suffering from serious tooth decay.

If pediatric dental care is among the list of 10 “essential health benefits” the government needs to stop the health insurance companies from not including this benefit within the health insurance bundle. This would allow then many families to afford dental care for their children by having it under the tax subsidy.


The Effects of Obama Care on Dental Coverage in the New Year

As of January 1, 2014 the new Obama Care or as it is more likely known as ACA or Affordable Care Act is to into affect. The idea behind Obama Care is to make all insurance more affordable for all United States citizens and make it more feasible for everyone to receive medical care without the fear of severe charges or denial of treatment due to lack of financial capability.

Will the Obama Care Mandate Affect Dental Coverage?

Well that answer is still in the gray area, it depends on if you are an adult or a child. If you are an adult who buys health coverage on their own or in a smaller group, dental coverage will not be mandated the same as medical coverage, it also doesn’t have to be offered in medical plans. While people won’t be penalized for not having dental coverage; depending on what state you are in depends on the type of coverage available through the new marketplaces.

What About Kids?

When it comes to children however, the ACA expands the availability of coverage for children up to 18 years of age. Anyone trying to figure out if paying for a dental plan out of pocket is cheaper than paying for monthly coverage, has more options to see what may be more affordable than no coverage at all. Dental coverage plans differ from state to state, except in Pennsylvania, Delaware and New Jersey pediatric dentistry must be required. There are stand alone coverage options that have pediatric dentistry along with 12 certified stand-alone dental plans.

How Much Will it Cost?

Stand-alone plans have been heard to be somewhat expensive; however there are plans that are as low as $25 a month all the way up to $40 a month on the high end. Which given the amount of dental care out of pocket, is a highly more viable option for most households to pay. The best change to this is there will be no longer be an annual cap on dental coverage.

What If I Already Have Insurance?

If you have insurance through your employer, there is less likely of any changes to your dental plan other than all coverage must include dental needs assessments for kids and doctor referrals to dentists.

What About the “Marketplace” I Keep Hearing About?

There are numerous plans available on the marketplaces and depending on what state you live in, depends on what coverage is available and it’s cost and inclusive benefits. Coverage for children is now considered an “essential benefit” in the insurance policies. The best benefit of this consideration shows that by 2018 8.7 million children will be covered with dental insurance and will have the dental health that is needed.

What Kind of Coverages Are Required?

In many states however it is imperative that the research of what each plan will cover for dental coverage is the biggest point. Some states requirements of services aren’t necessarily a better benefit. In some states while a cleaning and checkups are covered pretty fairly, cosmetic dentistry and restorative work may not be covered and come out of pocket.

When researching and discussing what plan works best for you, make sure to keep an eye out of the “fine print”. Changes are meant to help everyone, not cause hardships. Be sure to understand what plans are available and what is covered and what’s not, while at the same time making sure it’s affordable, as it is intended.

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