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Dental Coverage Under Obamacare (ACA)

Posted by on 9/10/2014
Dental Coverage Under Obamacare (ACA)

Currently, dental plans are not a primary component of coverage offered under the Affordable Care Act. However, certain contingencies exist for children, and as of 2015, a number of stand-alone dental plans will be made available by insurers.


According to the existing ACA guidelines, pediatric dental must be included on all insurance plans. These addendums allow coverage until the age of 19, even though the health insurance is valid until age 26. However, many of these dental plans are limited by the plan type, and the number of dentists that accept the insurance. For example, many on Medicaid based plans, or HMO's, can only visit a limited number of dental professionals.


Beginning in 2015, with open enrollment effective November 15th, a number of insurers will be offering add-on benefits. Of course, these benefits will be available at a cost, however, this would expand the available benefits and network of providers. Expected rates for these add-on plans range between $13-65 monthly for adults and an additional $8-34 for dependents.


The add-on plans, in addition to expanding coverage levels, should limit annual out of pocket costs as well. Currently, the out of pocket maximum on integrated plans is $12,500 annually, however, these add-ons are expected to offer maximums under $500 per individual.