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.

Important: You can buy a dental plan through the federal Marketplace only when you enroll in a health plan at the same time.

If you’re already enrolled in a Marketplace plan, you can’t add on dental coverage. You have to wait until the next Open Enrollment Period to change plans. If you qualify for a Special Enrollment Period, you can get dental coverage with your new 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 both. 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.

How to get Marketplace dental coverage

After you complete your Marketplace application and get your results, you can then view health plans that include dental coverage. If you decide you want a stand-alone dental plan, you can choose one after you select your health plan.

Note: You can’t buy a dental plan from the Marketplace unless you’re enrolling in a Marketplace health plan at the same time.

Dental plan categories: High and low

There are 2 categories of Marketplace dental plans: High and low coverage levels.

  • The high coverage level has higher premiums but lower copayments and deductibles. So you'll pay more every month, but you’ll pay less when you use dental services.

  • The low coverage level has lower premiums but higher copayments and deductibles. So you’ll pay less every month, but you'll pay more when you use dental services.

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 either 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 isn't an essential health benefit for adults. Insurers don’t have to offer adult dental coverage.

Note: Under the health care law, most people must have health coverage or pay a fee. Dental coverage is optional, even for children. So you don't need it to avoid the penalty.

More answers on Marketplace coverage

Can I cancel my Marketplace dental coverage and still keep my health 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 2016 Open Enrollment Period starts November 1, 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 with or without dental coverage. But you can’t get dental coverage on its own.