What plans cover

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 buy a dental plan through the federal Marketplace only when you enroll in a health plan.

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.

Dental plan categories: High and low

There are 2 types of Marketplace dental plans: High and low.

  • The high coverage level has higher premiums but lower copayments and deductibles.

  • The low coverage level has lower premiums but higher copays and deductibles.

When you compare dental plans in the Marketplace, you’ll find details about each plan’s costs, copayments, deductibles, and services covered.

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 health coverage for someone 18 or younger, dental coverage must be available for your child as part of a health plan or as a stand-alone plan. Note: While dental coverage for children must be available to you, you don’t have to buy it.
  • Dental coverage is not an essential health benefit 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 fee. But this isn’t true for dental coverage. You don’t need to have dental coverage, even for children, to avoid the penalty.

More answers on Marketplace coverage

  • It depends.

    • If you have a separate, stand-alone dental plan, you can cancel any time during the year by not making payments on the dental plan premium. This will cause your dental coverage to end. As long as you continue to pay your health plan premium, you’ll stay enrolled in your health plan.
    • Important: Don’t cancel your dental plan on HealthCare.gov if you want to keep your health plan. Selecting "Remove" in "My Plans and Programs" under your dental plan will cancel both your dental and health plans.
    • If you have a health plan that includes dental benefits and want to modify that plan, you can change to another health plan that doesn’t include dental benefits only during Open Enrollment. The 2015 Open Enrollment period ended February 15, 2015.

    Outside Open Enrollment, you can change health plans only if you have a qualifying life event that gives you a Special Enrollment Period (SEP). Learn more about how you qualify for a Special Enrollment Period. If you qualify for an SEP, you can choose a new health plan that doesn’t include dental coverage.