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The Affordable Care Act: Dental

The Affordable Care Act: The Ins and Outs of Dental Care for Children

The Affordable Care Act and all of its rules and regulations have been hitting the news for quite some time. One aspect of it that hasn’t been in the forefront of the news is dental care, especially how it affects children. There have been many changes, and analysts are saying there probably will be more, but there are some steady guidelines that parents can review.

What the Affordable Care Act Says

The mandate requires that all children ages 2-19 have dental health coverage. It also states that certification as “Quality Health Plans” (QHP) is required after January 1, 2014 for market plans of all individual and small groups, both in and out of the exchange. The exchange is the government’s directory of dental providers. This means that dentists and their practices will be regulated.

How Children are Covered Under the Plan

There are two Essential Health Benefits (EHB) plans—the Children’s Health Insurance Program plan and the MetLife High Option plan from the Federal Employee Dental and Vision Insurance Program. With the exception of the state of Utah, children will be covered by either one of these plans. Children in Utah will only be offered preventative services.

The Big Question: Does the Coverage have to be Purchased?

If patients are receiving coverage in a government exchange, it does not have to be purchased. However, outside of the exchange, meaning individual and small group market plans, plans do have to be purchased.

Under new federal law for dental insurance coverage for children, there are really only a few things parents need to know. First, children will be covered. Second, there are two plans to choose from the plan. Finally, if government exchange coverage is taken, it doesn’t have to be purchased. But, if an exchange outside of the network is taken, it does need to be purchased. Knowing these three things will point parents in the right direction when obtaining dental care insurance for their children.

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