Embedded Children’s Dental Coverage

Did you know that pediatric dental coverage is embedded in your Covered California Health Plan? That means that if you have children covered on you plan, they have dental benefits!

As one of the “10 Essential Health Benefits,” Children’s dental is required under the Affordable Care Act and therefore included in all Covered California Health Plans. This Covered CA dental benefit includes all preventive and diagnostic costs for children. That means that things like x-rays, exams, cleanings, and sealants are all covered as a benefit of you Covered California Health plan. Beyond that, the embedded coverage includes:

  • 20% of basic services and 50% of major services
  • 50% co-insurance after the health plan deductible is met on medically necessary orthodontics for children

Because the dental is one of the 10 essential health benefits, dental services are subject to the medical deductible and apply toward your out-of-pocket maximum on the health plan. For more information please review the Covered California 2016 Dental Plan Booklet

Carriers for Embedded Pediatric Dental Benefits