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Affordable Care Act Dental Coverages :
Affordable Care Act (ACA) is a comprehensive healthcare reform law. The enrolment period begins on 1 Nov and ends by mid Dec of the previous year. The ACA is quite complex and many people are unable to clearly understand the real benefits and coverage. This is truer when it comes to dental coverage. It is indeed difficult to get help from the healthcare market. Many private sites have come forward to give a clearer picture of the same.
ACA care for adults, children and Seniors
ACA does not seem to treat dental care as a health necessity. The ACA is not very helpful when it comes to adult dental insurance coverage for adults in Obamacare. The ACA does not insist on purchase of insurance plans. For dental coverage standalone policies are not eligible for federal subsidies. Hence you may end up buying a full healthcare coverage from the marketplace.
For children though the ACA specifies that pediatric dental coverage must be available it is not a legal requirement. Some states are known to have it mandatory.
The number of seniors is increasing at rapid rate. They are very much at risk for dental problems. Only 2% of retirees have dental coverage through their previous employers. Dental problems include dry mouth, tooth decay, gum disease and loss of teeth. The lifestyle of individuals is affected by these problems. A few state run market places allow them to purchase standalone dental plans without purchasing health insurance.
Traditional dental insurance
Many people opt for traditional dental insurance plans.
Dental insurance plans cover 100% of cleaning, check up and care (preventive care); 80% of basic teeth treatments like filling; 50% of more complex treatments like root canal and crowns. The coverage commences only after the deductible of $50-$180 is met. The main problem is that all insurance caps coverage at $1200 - $1500 annually.
There are two types of insurance plans. They are
- 1. PPO: This plan allows the member to get care from any dentist or dental specialist. However for new plan members the waiting period for coverage of expensive treatments like bridges and crowns is very long.
- 2. HMO: Here members have to stay within the network. When going to a dental specialist a referral from the primary dentist is needed. There is no waiting period like the PPO. The premium is also lower. The number of visits annually is limited.
Dental Savings Plan
One of the best alternatives emerging is the dental savings plan. Saving plans do not have spending caps or waiting period. They are activated with 72 hours. They do not require filling complicated forms or filing procedures.
Members save 10-60% on dental care. Dental savings plan also offers savings on general health care needs. They include prescriptions, vision and hearing services etc. There are also telemedicine plans which include free coverage with doctors to diagnose, treat and prescribe medicines for common ailments.
Discount plans also offer coverage form some services not covered by insurance like braces. For seniors, with existing oral problems, replacing teeth etc. can be done.
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