Quick Hit: Standalone Dental Plans can only be purchased WITH a full QHP at HC.gov
2018 MIDTERM ELECTION
Time: D H M S
I don't write about dental plan coverage very often; the only time I've ever really talked about it at length was my angry rant at the HHS Dept. on November 20, 2014 after it was discovered that someone at HHS/CMS screwed up royally by mistakenly lumping in several hundred thousand standalone dental plan enrollments with the full Qualified Health Plan enrollments, falsely making it look like the effectuated enrollment was around 7.3 million people as of August when in fact the number had fallen below the 7.0 million mark.
Otherwise, I don't really talk about dental plans much. There's actually two ways people can sign up for dental plans via the ACA exchanges: Either as "enhanced" QHPs (ie, full healthcare policies which also bundle dental coverage with them...which all of them really should IMHO, seeing how your teeth and gums are part of your body, after all), or as separate, standalone plans which are optional (that is, you don't have to have dental coverage in order to meet the ACA's Individual Mandate requirement).
Dental coverage is actually kind of an odd bird under the ACA. I'd normally expect it to be considered one of the "essential health benefits" which have to be covered...and it is...but only for children. Sort of:
Under the health care law, dental insurance is treated differently for adults and children 18 and under.
Dental coverage for children is an essential health benefit. This means if you’re getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan. Note: While dental coverage for children must be available to you, you don’t have to buy it.
Dental coverage isn't an essential health benefit for adults. Insurers don’t have to offer adult dental coverage.
Note: Under the health care law, most people must have health coverage or pay a fee. Dental coverage is optional, even for children. So you don't need it to avoid the penalty.
In other words, if I'm reading this right, the insurance carriers have to offer dental coverage for kids, but enrollees aren't required to buy it...while for adults, it's completely optional. Huh.
But wait, there's more! If you're enrolling via HealthCare.Gov (which covers 39 states this year), you can only enroll in a standalone dental plan after you've already enrolled in a Qualified Health Plan as well. In other words, you can't buy a standalone dental plan by itself:
In the Health Insurance Marketplace, you can get dental coverage 2 ways: as part of a health plan, or by itself through a separate, stand-alone dental plan.
Important: You can buy a dental plan through the federal Marketplace only when you enroll in a health plan at the same time.
Dental coverage is available 2 ways
- Health plans that include dental coverage. In the Marketplace, dental coverage is included in some health plans. You can see which plans include dental coverage when you compare them. If a health plan includes dental coverage, you’ll pay one monthly premium for both. The premium shown for the plan includes both health and dental coverage.
- Separate, stand-alone dental plans. In some cases separate, stand-alone plans are offered. You may want this if the health coverage you choose doesn’t include dental coverage, or if you want different dental coverage. If you choose a separate dental plan, you’ll pay a separate, additional premium.
I'm not sure whether this rule applies to the state-based exchanges as well as the federal one, but it's a useful bit of info.
Anyway, I realize this is a bit late in the game for me to be posting this, but someone brought it up on Twitter and I figured it might be helpful to some folks. Carry on.