Share

Choosing a Dental Plan Under ACA

Image of three diverse kids

Healthy teeth and gums are important for you and your children. Dental disease can affect your overall health, so it’s important that you and your children see a dentist regularly to stay healthy.

The Affordable Care Act (also commonly referred to as Obamacare) requires that the new health insurance exchanges offer dental plans for your children. Although the new act does not require dental coverage for adults, most state marketplaces will also offer dental coverage for adults. Visit HealthCare.gov to find out what plans you can purchase to help you with the cost of going to the dentist.

When you are considering buying a dental plan, the following are questions to consider when looking online at options:

  Will you and your children be able to see the dentist you want to see? 
  How far do you have to travel to see a dentist that accepts the dental plan?
  What is the monthly cost for dental coverage?
  Are your children eligible for help with the cost of going to the dentist under the ACA through tax credits or cost-sharing subsidies from the federal government?
  Is there an annual limit to what the plan will pay for your adult coverage? (There is no limit for children’s coverage.)
  How much of the cost does the plan cover for routine visits that may include dental cleanings, sealantsX-rays, and fluoride treatments?
  How much of the cost does the plan cover for fillingsroot canals, oral surgery (such as extractions), and treatment of gum disease?
  How much of the cost does the plan cover for major dental care (such as crownsdentures, fixed bridgesimplants or treatment for disease of the jaw joint)?
  Is there a waiting period before the plan covers certain care?
  Does the plan cover the cost of braces?
  How does the plan treat referrals to dentists who are specialists for things like root canals or gum disease treatment?

If you have questions or need additional assistance, you may call the Department of Health and Human Services’ Hotline at 1-800-318-2596. Even if you choose not to purchase a plan, you can still visit a dentist of your choice and ask if he or she provides flexible payment options.