2017 Winter Kansas Child

ACA Offers Private Dental Insurance For Kids
All across the country, the Affordable Care Act (ACA) is helping to make health care accessible to millions of people. In fact, six
years after its passage, 20 million more Americans now have health care coverage thanks to the ACA, and this number is expected
to grow as more people continue to seek the quality, affordable care they need.
In November 2016, Kansas kicked off another open enrollment period for the Health Insurance Marketplace. The Health Insurance
Marketplace is an online price comparison website where consumers can purchase health insurance. The Marketplace is open each
year during the annual open enrollment period. Open enrollment is the only time you can apply for cost assistance, enroll in a plan,
or switch plans without qualifying for a special enrollment period.
The ACA requires that pediatric dental coverage be offered on the
Marketplace, either as part of a qualified health plan (QHP) that
combines medical and dental coverage or as a stand-alone dental
plan, sold separately. This means that any child or adolescent
(age 0-18) enrolling in health coverage on the Marketplace is also
eligible to enroll in dental coverage.
In nearly all counties in Kansas there is at least one combined health
plan offered that includes pediatric dental coverage. For the 2017 plan
year, BlueCross BlueShield Kansas Solutions, Inc., is the only insurer
offering plans that include pediatric dental. However, this insurer does
not offer plans in Johnson or Wyandotte counties.
In addition to medical plans that include pediatric dental coverage,
families have the option to purchase their children’s health and dental
coverage through separate plans. These stand-alone dental plans may
also allow adults to purchase dental coverage for themselves at an
additional cost.
Families enrolling their children in a medical plan that does not
include dental insurance are not required to enroll them in a
dental plan.
Any plan offering pediatric dental coverage must cover preventive
and restorative services, such as cleanings, fluoride treatments,
dental sealants, X-rays, and fillings. Orthodontic services such as
braces typically are covered only when medically necessary. You
can find the full list of services at: https://www.insurekidsnow.gov/
state/ks/index.html.
When purchasing a dental plan separately from a medical plan,
families will be required to pay an additional monthly premium for
that dental coverage.
High-coverage dental plans have a lower deductible or copayment
at the dental office but a higher monthly fee. This means that a
family will pay more every month but less for dental services at the
time of the visit.
Low-coverage dental plans have lower premiums but higher
copayments and deductibles. A family will pay more when they use
dental services but less in monthly premiums.
When buying health insurance through the Marketplace, a family
might be able to get financial assistance to help pay their monthly
premiums. The amount of financial assistance available will
depend on the household income.
Families can use this assistance to help pay for any health plan
in the Marketplace, and get the same amount of assistance
no matter which health plan they buy. If families get enough
assistance to cover the full premium for a health plan and still
have money left over, they can use that money to pay for a
separate children’s dental plan. However, they cannot get financial
assistance if they are buying only a separate dental plan.
To compare dental plans in the Marketplace and find details about
each plan’s costs, copayments, deductibles, and services covered,
visit: https://www.healthcare.gov
Future of the ACA
The incoming Trump Administration has pledged to repeal and replace the ACA, which is also known as Obamacare. It is impossible
to say how, if or when the law will be replaced. Many parts of the ACA remain popular, including the provision that adult children
under age 26 can remain on their parent’s insurance policy, and the stipulation that people cannot be denied coverage if they have a
pre-existing condition. Today, the ACA remains the law of the land. More than 100,000 Kansans have been able to purchase health
insurance through the Marketplace, and the percent of Kansans who are uninsured dropped from 9 percent in 2009 to 6.3 percent in
2016 following the passage of the ACA.
For additional information regarding dental benefits in the Marketplace, contact Rachel Alexander at ralexander@oralhealthkansas.
org or 785-235-6039.
www.ks.childcareaware.org Kansas Child 21