Embedded Children’s Dental Coverage
Did you know your children’s dental insurance is already included in your Covered CA health plan? Yes, the Covered California pediatric dental plan is part of any family health plan you enroll in regardless of the metal level. So, if you include your kids in your health plan, they’ll also enjoy pediatric dental coverage benefits.
Children’s dental insurance is one of the 10 essential health benefits included in the Affordable Care Act. It’s also included in every Covered California health plan. This pediatric dental benefit takes care of the following:
- Diagnostic costs, such as X-ray, oral examination and tests
- Preventive costs like periodic cleaning and sealants
- Twenty percent of basic services
- Fifty percent of major services
- Fifty percent co-insurance on orthodontics for kids once the deductible for the health plan has been met
As a part of the essential health benefits of the ACA, dental services for your kids are also subject to the same rules as your medical deductible. They also count towards your maximum out-of-pocket costs for your health plan.
Details About Embedded Children’s Dental Insurance
- Preventive and diagnostic services are free and not subject to the stated medical deductible in your health plan.
- The cost of crowns, root canals and fillings are shared by the dental plan and the consumer.
- No out-of-pocket maximum is assigned to children’s dental costs.
- All your out-of-pocket costs for your children’s dental care may count towards the maximum out-of-pocket limit for your health plan.
- The maximum out-of-pocket for a silver health plan in 2017 was $10,800.
- If you choose a DHMO (Dental Health Maintenance Organization Plan), the costs of dental services offered by providers outside the plan’s network won’t be covered.
- Costs for covered dental services are different for most plans, so you need to do your research before visiting a dentist.
Companies Offering Pediatric Dental Coverage in California
Depending on the health plan you choose, your child will enjoy dental benefits offered by the companies below. Some of the companies also offer separate standalone family dental plans.
Covered CA Health Insurance Plan
Your child will get dental care benefits from any of the 11 health insurers in California:
- Kaiser Permanente
- Blue Shield
- Anthem Blue Cross
- Oscar Health Plan
- L.A. Care
- Sharp Health Plan
- Valley Health Plan
- Chinese Community
- Molina Healthcare
- Western Health Advantage
- Health Net
Stand Alone Children’s Dental Insurance Coverage Embedded in Health Insurance:
- Access Dental Plan (DHMO)
- Anthem Blue Cross (DPPO, DHMO)
- California Dental Network (DHMO)
- Delta Dental of California (DHMO)
- Dental Benefit Providers (DPPO)
- Liberty Dental Plan (DHMO)
Both embedded and standalone plans must be part of state exchange benefits programs. Covered California allows you to enjoy the benefits of child dental coverage through any of these programs.
Get a Quote for Your Child’s Dental Coverage
If you want to know more about pediatric dental insurance or whether you should opt for a standalone or embedded pediatric dental plan, we can help you make an informed choice. Give us a call now to get a detailed quote for each type of plan. We’ll also help you obtain maximum benefits from the dental plan included in the health plan you already have.
Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.
Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.
Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.
Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.