How to buy dental insurance in the health market

You may be surprised to learn that many American adults do not have dental insurance. A person with health insurance may not have dental coverage because insurers are not required to offer it to adults as part of their Affordable Care Act (ACA) compliant plans. .

It can be difficult to find a health insurance plan that offers dental coverage, and even then, your dental insurance will likely come with additional limitations and annual maximum benefits separate from your health insurance policy. If you are considering purchasing dental insurance from the health market, there are a few things you need to consider.

How to buy dental insurance in the health market

When referring to the marketplace in health care, the term refers to a place where you can browse and purchase private individual or family health care plans. Through a health marketyou can buy dental insurance in two main ways: through a health plan or through its own separate plan.

During open registration, you can create a profile and view health and dental plan options for the upcoming year. As long as you purchase coverage during open enrollment, your coverage will begin on January 1 of the following year and will last until the end of the calendar year. Under certain circumstances, you may also qualify for a special enrollment period that allows you to purchase insurance outside of the standard open enrollment period. Getting married, moving to a new state, and having a child are all circumstances that may qualify you for a special enrollment period.

Some states have created their own insurance market with state-specific providers, while others rely on the federal market. For example, Pennsylvania has created its own marketplace website called Pennywhile Tennessee residents will buy from the national health insurance market found at Healthcare.gov.

Below are ways to get dental insurance in the health care market.

Dental coverage under a health insurance plan

Although dental coverage is less often offered in conjunction with a health insurance plan, there are plans that offer both medical and dental coverage. You can compare different health plans to see which ones cover dental care. If a plan offers dental coverage, the cost will be included in the premiums you pay.

Keep in mind that health insurance providers are not required to offer dental coverage to adults who purchase ACA-compliant plans through their companies. Although dental care for children is a mandatory benefit under the ACA, this requirement does not apply to adults. It is therefore particularly important to know exactly what type of dental coverage is and is not included in your plan when purchasing insurance.

Dental coverage as a stand-alone plan

You can also purchase a standalone dental plan from the market. In this case, you would pay additional premiums for the coverage on top of the premiums you pay for your basic medical coverage. In addition to premiums, dental insurance that you purchase separately from health insurance will come with its own deductibles, copayments, annual maximums, and other limitations.

Benefits of Purchasing Dental Insurance in the Health Market

Purchasing dental insurance in the health market has its advantages. Whether you plan to get dental coverage through a health insurance plan or on your own, here are some benefits to consider:

• Easy comparison: When you research the market, it’s easy to compare different health and dental plans. You can see each plan’s copayments, deductibles, costs, and covered services in one place. When trying to find a health plan that includes dental insurance or trying to find a standalone dental plan, it’s easier to find a good plan when you can easily compare the different plans offered.
• Many choices : When you buy dental insurance in the market, you have access to both categories of dental plans. These categories include high-level hedging plans and low-level hedging plans. Higher-tier coverage plans offer higher premiums but lower co-payments and deductibles. Low-coverage plans offer lower premiums but higher co-payments and deductibles.
• Dental coverage is required for children: Through the ACA, insurers are required to provide dental coverage for children under the age of 18. Coverage can be offered as part of a plan or as a stand-alone plan, as it is considered an essential health benefit for children. This is an advantage if you have children, because you don’t have to worry about getting dental coverage for them like you would when buying an independent plan from a third-party insurance provider.

Disadvantages of buying ACA dental coverage

While the ACA can be beneficial, it also has drawbacks, especially when it comes to dental coverage. Cons of purchasing ACA dental coverage include:

• The ACA does not require dental coverage for adults: Dental insurance is not required to be offered by adult insurers, which can sometimes make it difficult to obtain when purchasing a health insurance plan. This means that you may have to review dozens of plans before you find one that offers dental benefits that suit your needs.
• Cost is not right for everyone: While the Affordable Care Act has made it easier for some people to access dental coverage, for others who are not eligible for subsidies, these market health care plans may not be affordable. If this is the situation you find yourself in, you might find independent dental plans more appealing, as you can find coverage for just a few dollars a month.
• Smaller provider networks: When implementing the ACA requirements, many insurance companies reduced their network of providers. This means that you will have fewer providers to choose from when purchasing a plan from this insurer. The effort to support and promote the ACA resulted in the shrinking of the program.
• Shopping can be complicated: Although a marketplace has all the options in one place, shopping for a plan can still be complicated. Registration periods are usually limited and sometimes there are so many options to choose from that you don’t know which one to choose.

How can consumers benefit from Medicare and Medicaid dental coverage?

To get Medicaid or Medicare dental coverage, you must qualify for the programs themselves. Medicaid is a state and federal program that provides health insurance to many Americans, especially those living on low incomes. Medicare is a federal health insurance program for seniors and people with certain disabilities. However, certain conditions must be met to be eligible for either program.

To qualify for Medicaid, you must be financially eligible, which means your income must be less than or equal to the established amount. To qualify for Medicare, you must be over age 65, have a qualifying disability, or have end-stage kidney disease. If you qualify for the program, you are automatically eligible for dental coverage.

Even if you qualify for one of these programs and their dental coverage, that doesn’t necessarily mean it will be easy to get. For Medicare, dental services are generally not covered, but there are options to choose from outside of the market. Depending on your age and income, you may look elsewhere. Some states may offer dental coverage through Medicaid, but this is not a state requirement.

Compare dental insurance

If you can’t find a dental insurance plan on the market, you can buy a separate plan. Benzinga offers information and reviews on the following dental insurance providers. Consider starting your insurance search using the links below.

Frequently Asked Questions

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