Does Health Insurance Cover Dental?
- You acquire dental coverage in one of two forms. The first is traditional insurance that pays a percentage of each treatment after you pay your deductibles and co-payments. Dental insurance requires a monthly premium and may enact a waiting period before you can visit a dentist. You can also choose to participate in a dental discount plan, which typically works with a limited number of dental providers to offer discounts on frequently used services including cleanings, fillings and root canals. Discount plans usually cost much less than traditional dental insurance.
- Private health insurance plans do not offer dental benefits. However, many providers offer dental insurance riders that provide dental coverage to the policy holder. These riders, along with vision, maternity and life insurance riders, are fully optional. Some employers that provide health insurance benefits may also provide a separate dental insurance plan for its employees. Alternatively, you can purchase individual or family health insurance in the private market as well.
- Some government-sponsored health insurance plans include dental benefits to the insured. For example, though Medicaid is a federal health program for low-income families, the states are responsible for regulating it. The federal government does not require Medicaid plans to offer dental coverage to adults over age 21. Less than half of states provide a comprehensive dental plan for adult Medicaid patients, but almost all of them cover emergency dental services. On the other hand, children under age 21 receive full dental coverage in every state under the child Medicaid program. As for Medicare patients, most dental services are excluded under the Social Security Act.
- The Affordable Care Act passed in 2010 does not apply to and exempts group dental and vision benefits. However, if you purchase an individual dental policy, the law may restrict lifetime and annual limits on coverage. Children are an exception to the rule. The law allows for preventive services, as well as essential treatments for pediatric patients.