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Oct 22 / Natasha Gayle

Does Obamacare Cover Dental?

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The government shutdown has ended and it’s time for all of us to look ahead toward the changes coming our way in 2014 concerning, most significantly, Obamacare—officially called the Affordable Care Act (ACA). Open enrollment for the ACA began October 1, 2013, but with so many modifications to our health care, many people still have questions about how the new health care law will affect their dental coverage. We hope to address some of the common concerns about dental care under the ACA and a solution that is both helpful and affordable for everyone.

Is Dental Care Covered?

Pediatric Oral Care

Pediatric oral care is included as part of the minimum Essential Health Benefits (EHB) package for small groups and individuals both inside and outside of exchanges. This means it must be made available to children under 18 years of age, but they are not required to have dental coverage under the federal exchange. (There are a few states, however, that do require pediatric oral care under their state-run exchange. You can find out which states have a state-run exchange on The Commonwealth Fund map). The EHB package may be included either as part of the medical policy purchased or as a stand-alone plan within the exchange. Each individual state will determine what this package will cover and what age limit to apply. The expectation is that in most exchanges it will cover the majority of services offered by the Children’s Health Insurance Program (CHIP)—such as exams, cleanings and fillings—for children 18 and under.

Some early supporters of the ACA, such as lawmakers and children’s health advocates, are concerned that families who don’t qualify for Medicaid or the Children’s Health Insurance Program may not be able to afford this.

If a stand-alone, pediatric dental policy is purchased from a federally run exchange, annual out-of-pocket expenses for families could be as high as $700 per child or $1,400 per family, according to Colin Reusch, a senior policy analyst with the Children’s Dental Health Project. Reusch also notes that the cost of stand-alone coverage will not count toward the medical out-of-pocket limit built into the health care insurance policy. Additionally, there will be no tax credits available to help pay for stand-alone pediatric dental plans like there are for medical premiums.

Adult Oral Care

Dental care for adults is not considered an Essential Health Benefit. Neither the Affordable Care Act nor most Medicare includes adult dental coverage. However, many exchanges (state or federal) will allow for non-pediatric dependents to be added onto the pediatric dental plan purchased. The benefits of the plan will likely not be as good for adults as they are for children.

An estimated 17.7 million adults could gain some type of dental coverage through the ACA, but overall the ACA will only reduce the number of adults who don’t have dental insurance by approximately five percent, according to the American Dentist Association.  And those who will benefit from the ACA will still need some assistance considering there will not be any subsidies offered in conjunction with the new healthcare law.

 What Will Happen to My Current Dental Coverage?

If you already have dental coverage, your plan shouldn’t change. Some companies may be cutting back on their dental coverage because of the increase in healthcare, but they should notify you of any changes before they are implemented.

[Update 11/20/2013: Since the writing of this article, your plan not changing is now up for debate. You should still be notified before any changes are implemented, but be aware that there are millions of people whose plans are changing as a result of the Affordable Care Act]

The UC Berkeley Labor Center predicts the Affordable Care Act will result in changes for some of the 150 million Americans who are covered through an employer-sponsored plan. Employers are not required to provide this coverage for their employees, but large employers with at least one full-time employee will be required to participate in the exchange or they will be subject to a penalty beginning in 2014.

If you find yourself in this situation or any other situation where you need to compromise your dental coverage, consider applying for a discount dental plan, which can be both cost-effective and readily available to you.

How Discount Dental Plans Can Help

With the many changes coming beginning January 1, 2014, and the millions estimated to either drop their dental coverage or lose it, discount dental plans can be a great help.

Discount dental plans will not be affected by the Affordable Care Act so current discount plan members will continue to receive discounts once the Act goes into effect, and new members will be able to receive the same rates offered to current members.

Anyone can be a part of a discount plan. The plans have low annual fees and huge discounts on dental work so they are affordable even with the increased costs of healthcare. These plans start immediately so there are no waiting periods and some discount plans even come with a free vision plan, which is another segment that is not covered for adults under the Affordable Care Act.

 

24 Comments

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  1. delores fatherree / Mar 10 2014

    have question…my job provides us max of $2000 for dental care…(delta-dental)
    they insist on extracting all by teeth due to peridontal disease…I have all 32 and yes some may need to be extracted and they will not give me a partial and wants to charge max $ 9,000 for everything…mine
    you it will cost me $7000…that’s ridiculous….will there be a problem with having delta and you discount plan and is there max also? i.e $2000 per year.

    • Natasha Gayle / Mar 11 2014

      No, there is not a limit of usage with our discount dental plan. If you are wanting to use both our discount dental plan and delta dental, you will need to speak with your provider and see if that is an option for you.

    • AllTheWiser / Mar 31 2014

      I once foolishly thought brushing and lack of cavities was enough and did not see a dentist for over 10 years. When I finally did go, it was a shocker. One dentist told me I needed six teeth removed due to severe gum disease/gums had receded;, deep pockets, etc. I got a second opinion, seeing a very good periodontist, who performed the deep scaling/debridement. I lost only two teeth initially. (A few years later, an inner gum infection flared and I lost another. If I had had the funds, I would liked to have had an implant done. It was the very back tooth, so I had an extraction.) But I am so glad I went for that second opinion and was able to save many of the teeth the original dentist said had to go.

  2. Deforest Cooper / Jan 30 2014

    Once I’m signed up for the dental plan, would i contact the doctor directly to discuss payment options, or is that something you can help me with? I would like to know, before signing up, if the doctor is able to accommodate payment arrangements or financing on dental work… :/
    Thank you

    - D. Cooper

    • Natasha Gayle / Feb 3 2014

      We can show you how much you will be saving with our dental plans at your dentist. However, for payment arrangements and financing, you’ll need to talk to your dentist to see what their policy is for that.

  3. brenda gallay / Jan 22 2014

    I am looking for dental insurance for my self i do have medicaid but when i call them they told me they only pay for children not for adult i think that wrong they should pay for adult to as well children i don’t think discount plans or saving are not that great b/c i live on ssdi and they don’t give me enough money to live on plus i am on fix income to i looking for a plan pays 100% i have really bad teeth where i can pay them every month i live indiana most my state are discount plans or savings plans and i want no waiting peroid to

    • Natasha Gayle / Jan 24 2014

      Unfortunately, you won’t find a plan that pays 100 percent of your dental care. Our discount dental plans aim to knock the price down as much as we can to help individuals and families pay for their dental care. If you haven’t seen our plans, please visit our website at http://www.1dental.com. Our plans do start immediately.

      I hope our dental plans can be a help to you, or that you find an insurance plan that meets your financial needs.

  4. donita stepke / Jan 11 2014

    According to ObamaCare… (what a joke this healthcare law is!)

    >Dental care for adults is not considered an Essential Health
    >Benefit. Neither the Affordable Care Act nor most Medicare
    >includes adult dental coverage. However, many exchanges
    >(state or federal) will allow for non-pediatric dependents
    >to be added onto the pediatric dental plan purchased.
    >The benefits of the plan will likely not be as good for
    >adults as they are for children.

    I really wish Obama had READ the “1700+ page Affordable Care Act” BEFORE SIGNING IT INTO LAW!! What kind of president enacts a LAW that will affect millions of here in America? A lousy one. He didn’t even read what we would get STUCK with. Moron. I am so disgusted in myself for ever voting for him, and the Democrats will never get a vote from me again.

    SO — Dental care for adults is not considered an Essential Health Benefit?? Not essential?? I have dental issues. I am disabled. MediCare doesn’t cover dental. Qualifying for MediCal costs me $600/month. I can’t afford that either. BUT, there are healthcare benefits for the Homeless — full dentures, crowns, extractions, fillings. Free. Out of our tax dollars. They get FULL coverage. The rest of us are stuck with nothing. I can’t afford $120 per tooth to be filled OR extracted. This blows my mind. Dental care is not considered an Essential Health Benefit. I’ll bet you that Obama, his wife, and his 2 daughters get dental care. They also get to have 3 vacations a year??…on OUR tax dollars?? What a bunch of CRAP. I’ll bet their DOG gets better benefits..

    Idiots…

    • Natasha Gayle / Jan 14 2014

      We realize this is a sensitive topic at the moment. Thank you for sharing your thoughts. Please let us know if we can answer any questions about your dental health needs!

    • Bmax / Jan 21 2014

      I’m sure he knew exactly what was in there. You have FAR too much faith in our current “leader”. The problem has nothing to do with him not knowing anything. Ignorance is always a choice. It’s caring that’s the real problem. Nobody gives a **** about the middle class, especially Obama.

    • VCos / Feb 3 2014

      Dear Ms./Mrs. Stepke, I read your complaints about dental coverage…and your criticisms about OUR President with whom I would gladly take over your choice of Mr. Bush. The answer for all of us is to accept what has been attempted by OUR President Barack Obama and add to it our concerns and wishes for dental coverage. You are WRONG when you say those benefits are given to the homeless. The only thing they get in California are teeth cleanings, and x-rays. NO fillings, crowns, dentures or anything your uninformed facts seems to tell you. I will always vote for a Democrat because they try to stand up for the poor and middle class. I am not rich nor unless I win some lottery will ever be. But, I do appreciate a man fighting tooth and nail to get healthcare for all Americans. If you have such hard feelings for the President then I am sure you have even harder feelings for the Congress who is blocking ALL attempts for OUR President to enact anything for people who are low or middle income.
      Please write to the President and Congress and tell all of the Republicans who are BLOCKING funding for us to knock it off and give us something for all of the hard work we put in to run this country. At least medical, dental, food, and housing. That is not tooooooo much to ask for as I put in those 9-5 days working for 8.50 an hour and ZERO health benefits what-so ever before “Obama Care”.
      Thank you

      • Natasha Gayle / Feb 3 2014

        Again, we realize this is a sensitive topic at the moment. Thank you for sharing your thoughts. Please let us know if we can answer any questions about your dental health needs!

    • Sandra Thomas / Feb 13 2014

      At least President Obama has made an effort to provide medical coverage for American citizens. Any new program will require modifications to add, remove or clarify parts of it. Maybe if there was more suggestions to improve it, rather than constant criticism, all will be able to benefit. There has been much talk about this subject to no avail, until President Obama made the effort. Kudos to him! Keep up the good work!

  5. Precyous / Jan 10 2014

    I do have both medcaid and medicare, live in SC. I don’t have dental coverage because of my age (over 21). Because of me being on a fix income amd a single mom, I don’t have 200+ to pay for dental. Will you tell me if the Obama dental insurane or something cheaper be est for me?

    • Natasha Gayle / Jan 14 2014

      Our discount dental plans would be a great help to you and your family! Our membership fees can be paid either annually or monthly: $75.06/year for one member, $129.06/year for two members. or $172.26/year for three or more members. Broken down by month, this would be $6.95 for one member, $11.95 for two members, or $15.95 for three or more members. With your membership, you can receive great, affordable dental care at the dentists in our network that you can see on our website at http://www.1dental.com. Please give us a call and one of our representatives can give you more information: 1-800-372-7615.

  6. frederick francis / Jan 2 2014

    Where do I sign up for Obama dental insurance ?

    • Natasha Gayle / Jan 2 2014

      You can sign up for Obamacare at https://www.healthcare.gov/. If you don’t find the prices you are looking for, consider one of our discount dental plans at http://www.1dental.com.

    • Diana Billington / Jan 11 2014

      My mother has been struggling with her teeth all her life. (age 60) She lives in NH and has no insurance. (she cant afford it) she is in pain all the time, she has no confidence, Very depressed, will not smile for anybody, and having trouble eating. (her teeth break and fall out in pieces)
      I feel so bad for her. Can someone find me a dentist who will except a reasonable down payment, and reasonable monthly payments? (that I can pay)
      Is there any way she can get help from the Obama plan?

      Thank you
      Diana

      • Natasha Gayle / Jan 14 2014

        Hi, Diana. Thank you for writing us. I’m so sorry your mother is going through this. While I’m not sure Obamacare is going to be much help in the way of dental, I can tell you about our discount dental plans. Our discount dental plans are affordable and offer our members great savings at the dentist. You may want to consider this as an option for getting your mother the dental care she needs. We have a large network of providers all over the U.S. When you call into our office at 1-800-372-7615 and speak to one of our representatives, they will be able to help you search for a dentist close to your mother that she would be able to go to with the plan. You can also search for dentists in her area on our website at http://www.1dental.com and see the different dental procedure prices we can get you with our savings plan. I hope this was helpful and that your mother gets the help she needs!

  7. James Martin / Dec 23 2013

    I am a disabled adult who lives in Florida, I collect disability and have Medicare, however no dentist in Florida accept Medicare and as such I am forced to live with dental issues that cause aggravating pain and force me to restrict my diet. I am not eating healthy and this escalates my disability, what am I to do?

    • Natasha Gayle / Jan 2 2014

      I am so sorry to hear that. One option I can suggest is to consider getting a discount dental plan. By signing up for a plan, you receive great affordable discounts on dental care so you can go to the dentist and take care of those dental issues. For more information, please call us and a representative will be able to explain more about the plan and the benefits it can offer you in your particular situation. Our number is 800-372-7615. You can also visit our website and look around for yourself at http://www.1dental.com. We have a huge network of dentists so you will never have to face what you do now as long as you stay in network. Additionally, one of our representatives will be able to look up your zip code and tell you how many dentists you have to choose from in your area with our plan. You can also do this yourself at http://www.1dental.com. I hope this was helpful!

  8. eva delong / Nov 15 2013

    so because i’m adult, if i need all my teeth removed and need dentures i’m on my own, so why bother even giving denta-cal. it’s apparent our government thinks american’s shouldn’t have the benefit of teeth to eat with or a smile their not ashamed of from no fault of their own, like taking a medication that destroyed their gums. I don’t see them cut from free dental care or free medical care. it’s clear they don’t care, only how it looks. I’ll be flushing my vote next time.

    • Natasha Gayle / Jan 2 2014

      Dental care is expensive and getting more expensive with the new law. However, there are still other ways to receive good dental care at an affordable price. We sell discount dental plans at 1dental that you may want to consider looking into. These plans were designed to save you money. You can find out more information about them at http://www.1dental.com.

  9. Richard Wagner / Oct 22 2013

    This is very useful information and should be common knowledge for anyone that may need healthcare in the near future.

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