Key Questions to Answer About Your Individual Dental Plan
In the wake of the marketplace registration deadline for the Affordable Care Act, many still have questions about individual dental insurance — what it covers, what it doesn’t, whether it’s mandatory, who is covered, etc. Whatever plan you choose, or are provided with by your employer, it’s always helpful to know the answers to a few key questions.
“What does my plan cover?” This is a fundamental component to any understanding of your dental coverage. Your provider should be able to provide you with a clear, concise list of procedures that are covered and procedures that aren’t, as well as the dollar amounts for which you are responsible. Ask about co-pays, reimbursement, and higher percentages for out-of-network dentists. Without exception, your plan should cover 100% of preventative care (cleanings, exams, x-rays, etc.). Provisions, if any, for cosmetic dental procedures such as dental implants and whitening should be clearly spelled out.
“Will I be able to check out of the health marketplace without dental insurance in my cart?” As of right now, yes, you can complete the purchase of your plan without including dental insurance, so it’s even more important that you make sure to purchase coverage from somewhere, since there won’t be any reminder.
“Can I purchase coverage from more than one place?” Yes, it’s possible to have overlapping coverage. If there is overlap, be sure you understand which plan will be most advantageous to you in each situation. And be sure with each individual dental insurance plan that you’re not paying for more than you actually need.
“Am I required to have dental coverage?” As of the deadline, adults were not required to purchase dental coverage through the marketplace. The Affordable Care Act does include provisions for children’s coverage, deeming it to be one of several “essential” benefits for children. As the evidence between oral health and overall physical health continues to accumulate, it’s possible that further revisions to the Affordable Care Act may include more dental provisions for adults as well. References. Good refereneces.