Does Obamacare Cover Dental and Vision?

As you know if you’ve previously had health insurance coverage through employer benefits or private insurance providers, the options for dental and vision care are diverse. Some policies include coverage for these areas of healthcare while others do not. In many cases, you have the option to tack on dental and vision coverage for an additional cost, or you can purchase separate policies to cover these types of healthcare services. Although Obamacare is essentially tasked with providing healthcare coverage options for all Americans, the program generally follows the same pattern as traditional insurance, which is to say, dental and vision may or may not be included in the policy you select.

Obamacare does not require that dental and vision coverage be included in healthcare policies, except in the case of children. As part of the Affordable Care Act (ACA), all plans that cover children are required to include both dental and vision coverage as part of minimum essential coverage. However, this requirement does not extend to adult policies. That said, there are all kinds of options available to adults seeking healthcare coverage, including dental and vision, through Obamacare. Some policies include one or both, and there are also options to add these types of coverage to existing policies as extras. You will have to take the time to understand how different options work and what they entail.

For starters, the dental and vision coverage offered through Obamacare may have limits on coverage. Typically, when you reach the limit of your healthcare coverage under the ACA, which is to say the maximum amount you are required to pay out-of-pocket, you won’t have to pay for anything – your insurance will pay all additional costs until the year rolls over and you once again have to pay your deductible and copays. The opposite is true for dental care (for adults). When you reach the maximum coverage for your policy, you will likely be required to pay 100% of additional costs, so it’s important that you understand how your policy works.

In addition, you need to know the differences between plan coverage and stand-alone policies, since both are options for adding dental and vision coverage under Obamacare. If, for example, you find a plan for coverage that includes dental, vision, or both, you may still qualify for cost assistance or tax credits. If you elect to purchase stand-alone policies in addition to your healthcare plan, cost assistance and tax credits will not apply to your dental and vision coverage. Don’t forget that stand-alone policies may be added or canceled without affecting your original healthcare plan. However, if dental or vision coverage are part of your healthcare policy (rather than stand-alone), they likely cannot be removed without canceling your entire policy.

Before you choose a plan, it’s also a good idea to understand what is covered. In some cases, certain oral surgery procedures may be included as part of your medical coverage. If you want coverage for routine exams and services, though, you’re going to need a policy that specifically includes dental and/or vision coverage, or you’ll have to purchase additional, stand-alone policies to gain the coverage you’re seeking.

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