Some parents may not be able to pay for their children’s dental care (“Affordable Care Act and Dental Care: Children”). Even though parents do not have to get pediatric dental coverage, depending on their state, this coverage could help them pay for their children’s dental work (Norris 2018). Parents can choose from many types of pediatric dental coverage.
Different types of pediatric dental coverage have their own benefits and caveats. Due to rules by the Affordable Care Act (ACA), pediatric dental coverage contain no lifetime and annual benefit limits (Norris 2018). Parents can either enroll into a stand-alone pediatric dental plan or a medical plan with pediatric dental benefits from federal and state-run health insurance exchanges (Norris 2018; “What Parents Should Know About Dental Coverage for Their Children under the ACA and Other Sources”). People with medical plans that contain embedded pediatric dental coverage usually pay higher maximum out-of-pocket amounts and deductibles than those with stand-alone pediatric dental plans (Norris 2018). Consequently, parents with the medical plans pay more out-of-pocket before the plan provides benefits for their children’s dental care (“What Parents Should Know About Dental Coverage for Their Children under the ACA and Other Sources”). Though, beneficiaries, depending on their annual income, family size, and other elements, can qualify “for subsidies to help pay the health insurance premium” (“What Parents Should Know About Dental Coverage for Their Children under the ACA and Other Sources”). For those who purchase a policy outside of the exchange, the insurance company must offer a policy with pediatric dental coverage unless the applicant already has “exchange-certified pediatric dental coverage…” (Norris 2018). While states determine which procedures are covered by the children’s dental plan, “[most] dental plans cover preventive and diagnostic care and common restorative care, like composite restorations. Some dental plans will cover 100 percent of the cost of preventive care” (“What Parents Should Know About Dental Coverage for their Children under the ACA and Other Sources”). These dental plans may also include coverage for medically necessary orthodontic procedures (“What Parents Should Know About Dental Coverage for their Children under the ACA and Other Sources”). For medical plans with embedded pediatric dental coverage, the medical insurance companies choose the dental benefits, such as routine cleanings (Norris 2018). Also, parents can access dental benefits for their children through Medicaid, “if parental income falls within a certain range” (“What Parents Should Know About Dental Coverage for Their Children under the ACA and Other Sources”). Alternatively, parents can utilize a dental savings plan for a low annual fee and with “no exclusions for preexisting conditions, no annual cap on costs, and no claims to file” (“Affordable Care Act and Dental Care: Children”).
The aforementioned plans are few examples of sources that provide pediatric dental coverage. Before enrolling into any type of plan, parents need to consider many factors, such as premiums, deductibles, out-of-pocket maximums, dentist network, etc. (“What Parents Should Know About Dental Coverage for Their Children under the ACA and Other Sources”).
Works Cited
“Affordable Care Act and Dental Care: Children.” DentalPlans.com. Accessed January 31, 2019.
https://www.dentalplans.com/affordable-care-act/children-dentalcare.
Norris, Louise. “Is pediatric dental coverage included in exchange plans?” healthinsurance.org,
April 30, 2018. https://www.healthinsurance.org/faqs/is-pediatric-dental-coverage-included-in-exchange-plans/.
“What Parents Should Know About Dental Coverage for Their Children under the ACA and
Other Sources.” American Academy of Pediatric Dentistry. Accessed January 31, 2019. http://www.mychildrensteeth.org/education/aca_coverage_for_children/
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