- Marketplace Overview
Can I get dental coverage in the Marketplace?
In the Health Insurance Marketplace, you can get dental coverage 2 ways: as part of a health plan, or by itself through a separate, stand-alone dental plan.
You can see plans and prices for stand-alone dental plans available in your area right now.
Dental coverage is available 2 ways
- Health plans that include dental coverage. In the Marketplace, dental coverage is included in some health plans. You can see which plans include dental coverage when you compare them.
If a health plan includes dental coverage, you’ll pay one monthly premium for everything. The premium shown for the plan includes both health and dental coverage.
- Separate, stand-alone dental plans. In some cases separate, stand-alone plans are offered. You may want this if the health coverage you choose doesn’t include dental coverage, or if you want different dental coverage.
If you choose a separate dental plan, you’ll pay a separate, additional premium.
Adult and child dental insurance in the Marketplace
Under the health care law, dental insurance is treated differently for adults and children 18 and under.
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 do not have to buy it.
This is not the case for adults. Insurers don’t have to offer adult dental coverage.
Under the health care law, most people must have health coverage or pay a penalty. But this isn’t true for dental coverage. You don’t need to have dental coverage, even for children, to avoid the penalty.
If I have Medicare, can I get a stand-alone dental plan through the Marketplace?
In most cases, no. If the Marketplace in your state is run by the federal government, you won’t be able buy a stand-alone dental plan. If your state is running its own Marketplace, you may be able to purchase a stand-alone dental plan.
Will I be able to cover all members of my family?
You can get dental coverage for all family members who are getting Marketplace insurance coverage, for some of them, or none of them. You cannot get dental-only coverage for someone who is not getting Marketplace insurance.
Will “guaranteed” and “estimated” prices appear in my Marketplace?
The guaranteed and estimated options won’t be available in all states.
- Guaranteed and estimated options apply in all states where a federal Health Insurance Marketplace operates. You’ll use this website, HealthCare.gov.
- You won’t necessarily find these two pricing options if you use a Marketplace operated by your state.
Do I have to provide dental coverage for my children?
No. Dental coverage for children 18 and under is an essential health benefit. This means child dental coverage must be available to you. This can happen through a health plan that includes child dental coverage or a free-standing, separate dental plan. But you can choose not to enroll in child dental coverage.
What are “guaranteed” and “estimated” prices for dental plans?
When you shop for separate, stand-alone dental plans in the Health Insurance Marketplace, look for one of two words next to the premium: “guaranteed” or “estimated.”
- “Guaranteed” means that the dental plan will charge you the rate that you see on the website.
- “Estimated” means the dental plans could cost you more than the price shown. You could be charged more based on your dental history, gender, line of work, or other factors.
A lower estimated rate may look less expensive than a plan with a guaranteed rate. But it might end up being more expensive.
You’ll find out from the dental insurance company what the actual premium will be before you pay your first premium.