ACA Pediatric Dentistry???

[Hermit]

Just finished getting DD signed up for health care. When she finished, she had to check several boxes saying she was aware that she had to sign up for pediatric dental care. She has no children, is not married, etc. Has anyone had experience with this

 

[MichaelB]

Coverage of pediatric vision and dental care are part of the 10 essential health benefits all policies must carry to comply with the ACA. The other 9 are outpatient care, emergency room, inpatient care, pregnancy, mental health & substance use, prescription drugs, screenings, chronic care services, and lab tests. See here https://www.healthcare.gov/blog/10-health-care-benefits-covered-in-the-health-insurance-marketplace/

 

[Hermit]

Coverage of pediatric vision and dental care are part of the 10 essential health benefits all policies must carry to comply with the ACA. The other 9 are outpatient care, emergency room, inpatient care, pregnancy, mental health & substance use, prescription drugs, screenings, chronic care services, and lab tests. See here https://www.healthcare.gov/blog/10-health-care-benefits-covered-in-the-health-insurance-marketplace/

So how do you buy health insurance for nobody?

 

[MichaelB]

So how do you buy health insurance for nobody?

?

Confused. I thought the policy was for your daughter.

 

[easysurfer]

So how do you buy health insurance for nobody?

Doesn't seem logical. But for BCBS, I think you'd check pediatric care for kids with a $0 premium, just to meet ACA requirements.

Would be nice if there was a no children so n/a option but that would make too much sense.

 

[audreyh1]

Just finished getting DD signed up for health care. When she finished, she had to check several boxes saying she was aware that she had to sign up for pediatric dental care. She has no children, is not married, etc. Has anyone had experience with this

Right. Both DH and I have pediatric dentistry coverage on our BCBS individual (adult) policies for $0. No way to opt out even though it doesn't cover us. A bit awkward, but it's an ACA requirement and that's how BCBS handles it.

And I found out last year (from this forum) that neither dental nor eyecare insurance low deductibles impact HSA compatibility, so I quit worrying about it.

 

[Hermit]

OP here. I just spent about an hour on hold with Humana trying to get the question answered. I finally gave up. I'll try again tomorrow. I hope Humana has something like the $0 cost, but I don't think that will be the case.

 

[jim584672]

I was puzzled about pediatric dentistry as well. Didn't see any way to not choose it.

 

[Calico]

Just finished getting DD signed up for health care. When she finished, she had to check several boxes saying she was aware that she had to sign up for pediatric dental care. She has no children, is not married, etc. Has anyone had experience with this

Yes.

Example #1: I don't have kids, and never have had any. I still pay local taxes to support the schools. Part of the price of being a member of the community, and I don't mind.

Example #2: My employer group health plan at work covers some conditions that only men are subject to, some that only women are subject to, and well-child visits. There is no "opt out" option for any of these. It is a group plan, not a cafeteria plan in which I can pick and choose what is covered.

 

[MBSC]

I purchased an adult individual ACA plan through the marketplace website in 2014. My renewal letter for 2015 states this plan no longer includes pediatric dental care and, if I needed such coverage, I would need to sign up for it seperately at an additional cost.

"Dental coverage for children is an essential health benefit. This means if you’re getting coverage for someone 18 or younger, dental coverage must be available as part of a health plan or as a stand-alone plan. While it must be available to you, you don’t have to buy it."
Source: https://www.healthcare.gov/coverage/dental-coverage/

Additional Info: https://www.alwayscarebenefits.com/PDFs/PPACA_FAQs_FINAL.PDF

 

[Hermit]

Yes.

Example #1: I don't have kids, and never have had any. I still pay local taxes to support the schools. Part of the price of being a member of the community, and I don't mind.

Example #2: My employer group health plan at work covers some conditions that only men are subject to, some that only women are subject to, and well-child visits. There is no "opt out" option for any of these. It is a group plan, not a cafeteria plan in which I can pick and choose what is covered.

My issue is not philosophical. I don't know what is required by the "law".

I purchased an adult individual ACA plan through the marketplace website in 2014. My renewal letter for 2015 states this plan no longer includes pediatric dental care and, if I needed such coverage, I would need to sign up for it seperately at an additional cost.

"Dental coverage for children is an essential health benefit. This means if you’re getting coverage for someone 18 or younger, dental coverage must be available as part of a health plan or as a stand-alone plan. While it must be available to you, you don’t have to buy it."
Source: https://www.healthcare.gov/coverage/dental-coverage/

Additional Info: https://www.alwayscarebenefits.com/PDFs/PPACA_FAQs_FINAL.PDF

Thanks SCGamecock for the following link:
https://www.healthcare.gov/coverage/dental-coverage/
The following quote is from the above link:

Under the health care law, most people must have health coverage or pay a fee. But this isn’t true for dental coverage. You don’t need to have dental coverage, even for children, to avoid the penalty.

The following link is to the official Colorado marketplace website:
Dental Options | Connect for Health Colorado
This following quote of from a link called "View this one page overview" in the above link:

Everyone must have pediatric dental coverage. However, if you do not have children, $0 or low-cost stand alone plans are available to meet this requirement.

The following quote is from the Colorado "Department of Regulatory Agencies Division of Insurance" Revised Bulletin No. B-4.57 Pediatric Dental Benefit Plans at this link - http://cdn.colorado.gov/cs/Satellit...goBlobs&blobwhere=1251982078289&ssbinary=true:

The Division recommends carriers utilize the following example of notification language for plans sold inside the Exchange that do not include pediatric dental coverage:

“This policy DOES NOT include coverage of pediatric dental services as required under the Affordable Care Act. Coverage of pediatric dental services is available for purchase in the State of Colorado and can be purchased as a stand-alone plan. Please contact your insurance carrier, agent, or Connect for Health Colorado if you wish to purchase either a plan that includes pediatric dental coverage or an Exchange-certified standalone dental plan that includes pediatric dental coverage.”

From the above information Colorado appears to say DD is required to have pediatric dental insurance and the Federal site says [-]pediatric[/-] dental coverage is not required.

Don't you just love it when our governments are so clear and concise And BTW, it took over an hour just to put this response together, let alone get a clear answer showing agreement by the various government entities.

 

[Hermit]

I think the problem is solved. I called Connect For Health Colorado, the official sign-up people for Colorado. The representative said they can annotate DD's records that she is signed up for the $0 cost pediatric dental coverage. I was on hold for an hour to get this piece of information. DD will have to be on hold another hour to actually get a representative to make the entry. The representative did give me an incident number that DD can reference to make it quicker.

Hermit