Many people are looking for a way out of the high penalties imposed on uninsured and under-insured individuals as part of the Affordable Care Act (ACA), or Obamacare. Obamacare’s individual mandate rises annually as an attempt to push people to get coverage wherever they can. For those who qualify, Medicaid and Medicare can be obtained. If you are shopping for insurance on state exchanges, then you may qualify for subsidized health insurance plans.
The Affordable Care Act has a list of essential health benefits that have to be included in certain health plans under Obamacare in order to meet minimum essential coverage standards. In it, dental insurance is treated differently for children and adults.
Age-Based Dental Insurance Requirements
Dental coverage is considered an essential health benefit for children 18 and under. So it’s required that you have dental coverage for your children, either within your health plan or as a stand-alone policy. It is important to note that although dental coverage for children has to be made available to you, it’s not required for you to purchase it.
For adults, dental coverage isn’t considered an essential health benefit. So you won’t find dental coverage included with certain health plans. Either way, you don’t have to worry about being penalized for not having dental coverage for yourself or children. However, you must have basic health coverage in order to avoid the individual mandate fee charged to the uninsured.
Dental Coverage Options
Dental insurance is available through the federal marketplace, but you must enroll into a health plan simultaneously. There are two types of dental plans you can acquire. The first is through you health plan. Some insurers offer plans that include both health and dental coverage. You can compare plans to see which of them offer both. In these plans, you will have to pay one monthly premium for both plans.
Stand-alone dental plans are available if dental coverage isn’t offered in your health plan. You can also purchase this if you don’t like the coverage offered in your health plan and would like to supplement it. Note that you’ll be paying two monthly premiums if you go this route.
Categories for Dental Insurance
There are two different categories of dental plans – high and low coverage. High coverage level dental plans have premiums that are higher, but come with lower deductibles and copayments. This is a good option for you if you don’t mind paying more each month in exchange for lower out-of-pocket costs from your dental visits.
The low coverage level is the opposite – it has lower monthly premiums in exchange for higher copayments. This is a better option if you have dental coverage for emergency purposes only. This way you won’t have to really worry about the higher copayments and deductibles.
You can learn more about the different dental plans by browsing through the marketplace. Make sure to pay close attention to the fine print in the policies to see what services are offered and what the out-of-pocket fees will be. The network of dental providers should also be checked, especially if you have a dental professional in mind. You can speak to an agent from your state marketplace for help selecting the right plan.
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