The dental plans that offer care to adults are stand-alone and come with no financial assistance. Covered California said the idea was “to offer affordable dental coverage to adults that was not available in 2014.”
The family dental plans sold by Covered California are optional and similar to those offered in the private market. Unlike the pediatric plans, they will not be available until “early 2015.”
Dental coverage for children will be embedded in all Covered California healthcare plans in 2015, as previously announced. Pediatric dental coverage was offered as a standalone policy in 2014, at extra charge.
Stand-alone dental plans often cap their total payouts at relatively low amounts, such as $1,000. Consumers end up paying a significant part of dental care costs, but for those who use the plans to their coverage limits they do provide value and some financial relief.
Out-of-pocket expenses incurred via the standalone dental policies do not count toward the general health insurance policies’ maximums.
The new optional plans come organized as dental health maintenance organizations (DHMOs) and dental preferred provider organizations (DPPOs). Carriers include Delta Dental, Dental Health Services, and Anthem Blue Cross and Blue Shield.
The so-called pediatric dental plans actually cover people up to age 19.
Children’s dental care is one of the essential health benefits under the Affordable Care Act, but states can offer the coverage separately from the private insurance they sell under Obamacare. For this year, 2014, the Covered California board decided to do that, promising children’s advocates that the decision would be revisited.
The state insurance commissioner and some children’s services activists had criticized the health insurance exchange’s decision not to roll dental care for young people into basic family plans in 2014.
The included dental care policies that cover children and teens come from providers such as Delta Dental (Kaiser, Chinese Community), Dental Benefit (Health Net) and Liberty Dental (L.A. Care, Valley Health), list below.
Covered California said that despite pediatric care being included in overall health plans, some families might decide to add their children to the standalone dental family plans sold through the exchange — typically in order to continue with a preferred dentist. Adding children would result in additional costs, the state Affordable Care Act operation cautioned, as the children already would be covered by the embedded plan.
“This is great news for families and children, because all children enrolled in Covered California will have dental coverage embedded in their comprehensive health plan,” Covered California Executive Director Peter Lee said. “They will be getting better coverage and more for their money.”
Here are the new optional family dental plans:
Here are the “embedded” pediatric dental plans (no extra cost):