Children require dental care just like adults do. For children’s overall oral health to be maintained, it is important for them to visit their dentist twice a year, as recommended by the American Dental Association. This not only ensures healthy, strong teeth, but also establishes good oral health habits early on. This type of preventative protocol was reinforced and mandated by the Affordable Cara Act (ACA) in 2014.
Pediatric dental coverage is an ACA Essential Health Benefit that must be offered to families buying health insurance in the new state- and federally-facilitated marketplaces (“exchanges”) in the individual and small-group insurance markets. Depending on the state, pediatric dental benefits may be offered in up to three ways:
- Through a qualified health plan (QHP) that includes dental coverage (embedded)
- Through a stand-alone dental plan purchased in conjunction with a QHP
- Through a contracted/bundled plan (one premium for separate medical and dental policies)
Do families have to buy pediatric dental coverage?
Unless a state requires it, separate pediatric dental coverage is not a required purchase inside the new exchanges. However, outside of the exchanges, individuals purchasing individual or small-group coverage must purchase pediatric dental coverage through their health plan or give “reasonable assurance” that they have purchased it through an exchange-certified stand-alone dental plan.
Dr. Panico’s dental office suggests calling your insurance company or human resource department if you are not sure whether you have pediatric dental benefits for your children. Some people don’t realize they have coverage that they have already paid premiums for, therefore those benefits go unused. Be sure to question if you have pediatric dental benefits with your insurance plan so you can give your children bright, healthy smiles that last a lifetime!
Dr. William Panico’s office is located at 4 Oslo Ave., Rio Grande. Call (609) 886-2277 to schedule an appointment. Saturday appointments are available. Visit www.panicodental.com for more information.
