Adult Dental Coverage under Affordable Care Act

The greatest majority of physicians are medical doctors, such as MDs or Dos. However, there are a few specialists in the healthcare field which are not medical doctors, such as DDS/DMD dentists, DPM (podiatrists), or OD (Optometrists).

So will the Affordable Care Act offer coverage for treatments performed by non-medical doctors or not?

The answer is that under ACA patients can get eligible for dental coverage, but it depends on which marketplace plan a family or an individual chooses. Other treatment by non-medical doctors will also be covered.

According to Kathy Young, CEO of the St. Joseph Hospital, the ACA will cover treatment offered by specialists such as osteopaths. Both MDs and DOs are regarded as physicians under the law, so the new reform will include coverage offered by such specialists.

Regarding dental care under the ACA, there is a differentiation when it comes to dental insurance for adults, and dental insurance for children under 18 years old.

Dental care coverage for kids under 18 is viewed as an essential type of benefit, which means that it must be offered either through a standalone plan or as a partial inclusion of a health plan.

CEO Kathy Young further notes that insurers are not obliged to offer dental coverage for adults. However, there will are two important options available for adults for getting the dental coverage they require.

Dental Coverage on the Marketplace

Some of the general health plans that can be purchased in the Marketplace will have dental benefits included. When people are comparison shopping for health plans, they should also check and compare different plans that include dental coverage.

The extent of coverage will also differ from one plan to the other, so it is important to check thoroughly before buying.

When the dental benefit is included in the health plan you buy in the Marketplace, there will be only one premium you will pay for the entire package and get coverage for everything that is displayed within the plan.

Standalone Dental Plans

Separate dental coverage might also be an option. This means that people will buy one separate insurance which offers coverage only for dental care.

In case the health plan you enrolled into does not include any dental benefits, opting for a separate dental plan as well, might be the best option.

People who will purchase standalone dental plans will be required to pay separate premiums for their dental insurance plan.