The Affordable Care Act requires health insurance
marketplaces to offer pediatric dental benefits to all consumers, whether or
not a consumer has children. Dental
benefits for adults are not required, but some health plans may offer
them. There are also stand-alone dental
plans available in every state, some offering only pediatric dental benefits
while others offer family services.
Currently confusion reigns concerning dental benefits
offered by various plans. Ambiguous
information about medical plans with embedded pediatric dental benefits and about
stand-alone dental plans as well means it is virtually impossible for consumers
to make informed choices about which plan to buy.
Among medical plans with embedded pediatric dental benefits,
34% do not have a separate dental deductible which means the consumer will have
to meet significant medical deductibles before receiving any dental
benefits. One recent study reported
consumers in this group might have to meet an annual deductible of almost
$3,000 for other healthcare services before receiving any benefits toward
dental care.
This is a typical
example of the lack of transparency and limited information available to
potential buyers of healthcare insurance.
Many national and state professional dental organizations are working to
improve transparency of dental benefit plans, but no action has yet resulted in
clarification of what is available in various marketplaces or how one plan
compares to another.
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