The Simple Clarity of Dental Insurance

While Dental Insurance is a topic that can seem overwhelming, it really doesn’t need to be complicated.

In this article, we answer many common questions and show you how easy it is to get coverage that is fast, effective, and simple.

My Children have Dental insurance through coverage purchased through the Health Insurance Exchange as part of the Affordable Care Act.  Do I still need dental insurance for me or for them?

Many people are not aware that their children have limited “Pediatric Dental” benefits and coverage under a health plan purchased through the Exchange (www.healthcare.gov)

But what does that mean and how extensive is the coverage?:

The Affordable Care Act does provide some “Pediatric Dental” coverage for anyone under the age of 19 if they are covered on a Health plan through the Exchange.  Most of the time (it does vary by State) preventative benefits are covered. Preventative typically refers to exam, cleaning (Sometimes X-rays and possibly 1 filling) and major work is not covered (oral surgery, crowns, bridges, extractions etc….)  

There is some “pediatric dental” coverage available on health plans purchased outside the exchange.  Meaning coverage is available through an Employer’s plan or an individual plan purchased outside the exchange; however you will want to do some checking to see if your health plan offers this as it is not required in most instances.

So the question is, should I still purchase Dental Insurance?:

The answer is yes, even if it is just for the Adults (age 19 and older) on the plan.  You will most likely come out ahead financially. The cost of the premium will nearly be swallowed up just in you using your preventative benefit which is usually covered 100%.  So if you add up the premium you pay each month and then figure how much an exam, cleaning and X-rays cost every six months you will typically break even, meaning if you did not have dental insurance and just paid out of pocket for “Preventative benefits” most likely that yearly expense would be very close to what a yearly premium would be to have dental and preventative covered 100%.  

So why buy dental insurance if it is a wash? The reason, because odds are you are going to have need of additional work the needs to be done. For example, fillings, extractions, oral surgery, wisdom teeth, crowns, bridges etc….. having dental insurance would greatly help in the out of pocket cost of a more major procedures.

What if my children have preventative dental coverage through an Affordable Care Health plan purchased through the Exchange, should you still buy dental insurance?:

Yes!!! Why, because the pediatric dental coverage they have is very limited and does not cover and of the high dollar needs they may encounter.