The Children's Dental Health Project's blog
An updated resource for families during open enrollment
November 1 marks the start of open enrollment for the state health insurance marketplaces’ 2019 plan year. As CDHP has previously noted, buying dental coverage on the marketplaces can be complicated. This year, the administration dramatically reduced federal funds for navigators, groups established to help consumers seeking to get covered. As many communities may have less navigator support this year, resources that help families better understand their options may be all the more important.
CDHP and Families USA have updated our guide, Buying Dental Coverage in the Marketplace.
Families may have also heard a barrage of news stories about federal regulatory changes that undermine safeguards for consumers put in place by the Affordable Care Act (ACA). For example, the administration has recently allowed short-term health plans to have longer coverage periods, despite their limited benefits. Such insurance options aren’t required to adhere to ACA rules that protect family financial security or cover guaranteed benefits. Under the law, coverage sold on the marketplace must offer all 10 essential health benefits, which includes children’s dental coverage. By contrast, short-term plans have no obligation to do so.
"We hope our guide will ease some of the stress of shopping for coverage."
Plans sold this year in the health insurance marketplace, however, must still comply with ACA standards. And yet, that doesn’t mean that the process to buy dental coverage for children will be straightforward. While kids’ dental coverage must be offered as part of the essential health benefits, dental coverage can still be sold separately in most state marketplaces. It may not be integrated in the medical insurance plans available to children and families shopping for coverage. This means that that families must often shop for multiple products, pay more than one premium, and navigate different sets of rules depending on where they live and what plans are available.
It’s important for families to take time to review which health plans do or do not cover their children’s dental needs. They should also pay attention to how health plan deductibles apply to dental services, or whether they’ll face additional out-of-pocket costs when buying a separate dental plan.
We hope our guide will ease some of the stress of shopping for coverage with these needs in mind. Whether you are an advocate, a medical or dental professional, or other community partner, we invite you to share this resource with parents and caregivers in your area. Together we can support families in choosing the plan that best meets their children’s oral health care needs.
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