The new health insurance marketplaces within Obamacare allow for dental insurance coverage options. However, finding information on what dental services are covered by each plan is difficult, according to the American Dental Association (ADA) Health Policy Resources Center in the April 21, 2014, edition of the ADA News.
It is true that Obamacare (the Affordable Care Act, ACA) requires small groups and individual marketplaces to offer dental benefits for children. While adult dental benefits are not required under Obamacare they are available within either medical or dental plans. Because the information presented is not very clear it is difficult for consumers to select the best plan for them or their family. It is also true that the plans vary by state, thus creating much of a variety. Many of the plans across the country offer deductibles or coinsurance amounts that apply to preventive pediatric dental services; the consumer thus has out-of-pocket expense that they were perhaps led to believe did not exist. This limits accessibility as promised by this President and his administration. There are financial barriers to obtaining care with the lack of first dollar coverage.
The ADA Health Policy Resources Center also found that 34% of medical plans with included dental benefits for children do not have a separate dental deductible, which is a variation from common dental benefits in the private dental insurance market. This means that consumers in these medical plans will have to meet a higher medical deductible in order for the plan to assist in paying for dental services. Clearly much of this information is unclear to consumers; there is clearly no transparency in the dental coverage details.
We all know these plans are new. However, the “wheel” of dental insurance coverage has already been invented. Moreover, the promises of transparency and accessibility do not exist currently. The ADA continues to lobby for the government to provide more information to consumers. The ADA is a huge advocate for patients, nationwide. The ADA has lobbied for dental plan transparency since the beginning of ACA implementation, according to Dr. Carmine LoMonaco, the chair of the ADA Council on Government Affairs. The ADA will continue its efforts in this regard to enhance transparency and hopefully to enhance consumer access to dental care.