How the Affordable Care Acts Impacts Dental Coverage

Family Dentist Oregon City ACAEven though the Affordable Care Act – commonly referred to as Obamacare – has been in effect since the beginning of the year, many people still have questions about how the law will impact health insurance benefits. One aspect of the law that hasn’t received much publicity is how the ACA affects dental insurance. To help you better understand ACA’s impact on oral care, here are the answers to some commonly asked questions.

Is dental care covered as part of the ACA?

Yes, but not comprehensibly. The ACA only requires that certain health plans offer affordable dental care benefits for children, not for adults or seniors. Despite the limited scope of this provision, experts forecast that 1.7 million kids currently without health insurance will now have access to the care they need due to the law.

How do you get dental coverage for kids under the ACA?

Prior to the enactment of the Affordable Care Act, if an employer didn’t offer dental coverage, it was difficult and cost prohibitive to shop around for a dental only plan. Now, the insurance exchanges offer an all-in-one shopping experience where consumers can compare plans and purchase dental insurance. However, the rules currently in place don’t require you add dental insurance to your “shopping cart” when purchasing a plan, so you need to make sure you selected a plan that features dental benefits or selected a separate dental plan before finalizing your purchase.

How to pick the right plan for your family?

Whether federal or state run, ACA exchanges offer helpful navigators that provide you with information on how to make the right selection for you and your family. However, there are a few tips to keep in mind when comparing coverage:

  • If you are purchasing coverage for you and a child, look for plans marked “EHB-compliant,” as these plans include pediatric dental benefits.
  • If you or a child need orthodontic treatments that may not meet a “medically necessary” requirement, you may want to look at plans off the exchange that may feature more flexible dental coverage.
  • Make sure any plan you choose covers preventative care such as dental exams, x-rays and cleanings.
  • If you have and like your dentist, make sure you pick a plan in which your dentist participates.

Do you need to buy dental insurance?

While you’re not legally required to carry dental coverage, oral disease can cost thousands of dollars in out-of-pocket expenses and can cause severe discomfort if left untreated. However, the majority of dental problems are preventable if you receive the proper care, such as undergoing regular cleanings, x-rays and exams.

What does dental insurance cost?

Consumers who qualify will be eligible for tax credits that will help to offset some of the cost. However, the majority of any tax credit you receive will go towards the cost of a base medical plan, which means few, if any, dollars will remain for adding any additional dental insurance.

Where do you buy?

The state of Oregon just officially announced that will shut down due to website’s ineffectiveness. Oregon residents wanting to enroll in health care through an exchange will need to use the federal government’s website,, to enroll. Open enrollment has closed for 2014, so if you don’t currently have coverage, you cannot enroll in health insurance through the marketplace until November 15, 2014.

If you need a family dentist Oregon City, please contact our office today to get started!