Need dental insurance? You may be able to get it through the Affordable Care Act’s health insurance exchanges. Here’s how it works on the federal exchange. If your state has its own exchange, the rules may vary.
You have to buy health insurance on the exchange in order to buy a dental plan. You can’t use the exchange just to buy dental insurance if you’re getting your health insurance elsewhere.
Some health insurance plans on the exchange will include dental coverage. In that case, if you buy the health plan, the dental coverage comes with it and the cost of both health and dental coverage are bundled together in your health insurance premium. You only write one check each month.
What if the health plan you choose doesn’t include dental coverage? You can buy stand-alone dental insurance through the exchange at the same time you buy your health insurance as long as there is a plan being offered in your geographic area. In this case, you will pay two separate premiums each month: one for health insurance, one for dental insurance.
Special Rules for Kids
Since it’s one of the essential health benefits for children, health insurance companies that sell health insurance for kids have to provide dental coverage for the child. Some health plans will include this as part of the health insurance; some will provide the coverage as a stand-alone plan paired with the child’s health plan. Dental benefits aren’t an essential health benefit for adults, so health plans don’t have to provide adult dental coverage.
A Caveat for People Getting a Health Insurance Subsidy
If your adult health plan includes dental benefits, the dental coverage is an extra, non-essential benefit. A health plan might add extra benefits like this to entice you to choose it over its competitors. However, if you get a health insurance subsidy through the exchange, be aware that cost-sharing subsidies only apply to covered essential health benefits. For example, if you receive a subsidy to reduce your out-of-pocket maximum, that reduction only applies to the essential health benefits, not to non-essential benefits.
About Health Insurance Exchanges
The Affordable Care Act allows each state to choose either to establish its own health insurance exchange, or to have the federal government run the exchange for residents of that state. With the Healthcare.gov site’s Marketplace-finder tool, you can find out whether your state has its own exchange or if residents of your state use the federal exchange. The tool will also provide contact information for each of the state-run exchanges.
Dental insurance isn’t available on every state-run exchange. If your state-run exchange offers adult dental insurance policies, the rules may be a bit different than they are for dental insurance sold on the federal exchange. However, each exchange has people available to answer your questions both over the telephone and online.