PEDIATRIC DENTAL PROVISION

All new 2014 Essential Benefit Plans must cover pediatric (under age 18) dental and vision. These are actual insurance plans. By that I mean they are not low cost discount plans. They also will cover medically necessary orthodontics. They only cover the children. Adults will still have to purchase their own dental plans.

Dental is NOT unlimited coverage. Each plan will have an annual out of pocket maximum like other dental plans. The consumer should be aware of the provider network. Is there out of network coverage?

I have become aware of two areas of consumer caution. One carrier does not offer pediatric dental coverage on the Marketplace. How is this possible?

Delta Dental is on the Marketplace. The government has allowed insurance carriers to offer plans without pediatric dental on the Marketplace with the understanding that the consumer MUST purchase a dental plan for their children. So far I only know of one insurance company selling Marketplace plans without pediatric dental. If a purchase is made from that company AND there are dependent children on the plan, these people MUST purchase a dental plan for their children.

The second caution is there is a major Insurance Company that has made their new group Insurance plans so that the pediatric dental is subject to the Medical Deductible. Think about that. You bring you child to a dentist only to find out that the check up, which is suppose to be covered at 100%, is fully charged to you as part of your medical deductible.

With everything regarding your healthcare in 2014, BE AWARE!

2014 looks like it will be a year of learning for everyone.

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