For Support Call: 888­-704-8243

Is Dental an Essential Health Benefit

The Affordable Care Act is an extremely broad set of rules and regulations that set the tone for the health insurance industry and millions of people across the country. A revolutionary and comprehensive law, it’s not always easy to understand what benefits you are entitled to under the minimum essential health benefits and what you can expect to pay for outside of your traditional coverage. Just a few of the accomplishments of the act include integrating more care delivery, expanding medical coverage for individuals across America, and ushering in major financing changes for the industry.

There are several different factors that influence how dental benefits fit into this picture. Dental coverage is required for children under the Affordable Care Act, but not for adults. There are 10 essential health benefits that all health insurance plans under the Affordable Care Act must have, and pediatric dental benefits is one of these 10 essentials.

For adults, the most important implications for dental benefits are with regard to the expansion of Medicaid. It’s projected that up to 17.7 million adults could get dental benefits through Medcaid. However, this concept relies on the idea that all states provide extensive dental benefits, which is not the case. It’s more likely that about 4.5 million more individuals will get extensive dental coverage through Medicaid under the Affordable Care Act.

Many health insurance plans that are offered on the health insurance exchanges, however, do have dental benefits. As a result of these broad plans that give individuals access to both medical and dental coverage, it’s expected that nearly 800,000 adults will obtain dental benefits by opting for a plan with these included via the health insurance exchange.

It’s critical to read all the fine details about your policy before purchasing it. This will help you understand, for example, whether you will be getting dental benefits or whether you would need to find those outside of your health insurance plan. Your employer may offer a dental plan, for example, or you could purchase one of your own from a range of private dental insurance companies located in your state. Although some insurance companies on the health insurance exchange might offer dental, the vast majority do not. If you need dental benefits as part of your overall coverage, it’s recommended that you budget this into your overall medical expenses for the upcoming year.