Children’s dental plans unveiled

Dental care plans for children and teens will be offered by six insurers via the California health exchange.

Children's insurance providing braces coverageCoverage is optional and not included in general health plans offered by the Covered California marketplace, which opens for business Oct. 1.

Rates for the “pediatric dental plans” range from $10 to $30 a month. Dental coverage is not offered to adults but reportedly is under consideration for 2015.

The six companies unveiled June 25 are Anthem Dental, Blue Shield of California, Delta Dental of California, Health Net Dental, Liberty Dental Plan and Premier Access Dental.

The dental plans cover those up to 19 years old. Not all plans are available in all areas, as with the regular health insurance plans offered by Covered California.

The rates and plans do not affect insurance benefits offered by employers, which is how most people receive dental care.

The news comes days after a Pew study that shows 1 in 4 U.S. children don’t have access to dental care. Children on Medicare (Medi-Cal in California) are more likely to receive care, but they’re still underserved because most dentists don’t accept publicly insured patients. In California, about six in 10 dentists don’t take Medicare.

Children newly insured under the Affordable Care Act marketplaces “will enter a dental care system that does not deliver services to all those currently insured, whether through private or public coverage,” the Pew study said.

States have the option of including pediatric dental care under the federal Affordable Care Act. California chose to offer the coverage under separate plans. The state insurance commissioner is pressing Covered California to include the coverage under its basic health plans.

State Assembly member Dan Logue, R-Marysville, said older adult buyers of insurance should not have to subsidize pediatric dental care. He warns of “system collapse” if all individual health needs are covered under Obamacare.

Covered California says the separate dental plans offer families more options.

“Dental care is a vital component of overall health, and especially critical for our state’s children,” Covered California chief Peter Lee said. “Access to dental services as a youngster means better health, both for children and as they get older.”

Covered California said its dental benefit plans feature the usual copayments, deductibles and coinsurance requirements. The pediatric dental care does not come in the three “metal” levels used by standard health insurance under the exchange, however.

Under the pediatric dental plans to be offered in 2014, consumers have a choice of paying more for the coverage and less in copayments, or the reverse. The options are 85 percent of total cost coverage and 70 percent coverage.

The new plans operate as dental health maintenance organizations (DHMOs), dental preferred provider organizations (DPPOs) and dental exclusive provider organizations (DEPOs). DHMOs are the most restrictive in terms of choice of dental care providers.

In Los Angeles, for example, Blue Shield’s charge for a DHMO plan at 85 percent covered is $11 a month. For Blue Shield’s DPPO, that rate is $22.

Out of pocket maximums for pediatric dental care range from none (DHMOs) to $1,000 per year (DPPOs).

Out of pocket expenses incurred for the dental will not count toward the general health insurance policies’ maximums. Health care activists have asked for this to be changed.

Under the new Covered California exchange plans for children and teens, Health Net Dental will be available only as a bundled option. The other five insurers’ plans are all stand-alones.

Coverage bought via the exchange goes into effect Jan. 1, 2014.

Lee said the optional coverage was “particularly important for consumers of child-only coverage and family plans.”

The 13 providers selected for general health care coverage via Covered California include dental plan providers Anthem and Blue Shield, which are sister companies.

View the Children’s Dental Insurance plan rates for 2014 (PDF)
Read the Pew Trust study “In Search of Dental Care” (PDF)


  1. It is good to hear about the children dental plans — great that rates range from $10 to $30 a month. This is a good option for all the people who are looking for child dental plans — even i was looking for this for my son.

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