October 9th, 2019 BY HealthNetwork
Depending on who you ask, you may find different opinions on when kids should start seeing a dentist. Some pediatricians and dentists recommend early screenings to get children used to the habit while others suggest waiting until kids turn three for a real dental cleaning. Official word from the American Academy of Pediatric Dentistry (AAPD) says that children should see a dentist as soon as the first tooth erupts but no later than a year old. Whenever you decide to take your kiddo to the dentist, you’ll want good dental insurance in place to make sure the visit is covered. You might think that paying out of pocket for a couple cleanings each year isn’t bad – and it’s not – but routine cleanings aren’t the only benefit to good dental coverage. Here’s why you might need dental insurance for your kids.
Early Childhood Dental Care
Early childhood dental care sets the stage for good oral health and habits as your child grows. Primary (“baby”) teeth are just as important as permanent teeth because they:
- Help with chewing
- Help with speaking
- Act as placeholders for adult teeth
In addition, tooth decay can begin as soon as your child’s first tooth appears. You might think that this isn’t a big deal since baby teeth fall out anyway, but decay of the primary teeth can lead to a higher risk of decay later on. Plus, serious primary tooth decay can affect your child’s general health. Tooth decay is the most common chronic disease young children suffer in the United States. Establishing good dental habits from the outset, including twice-yearly dental checkups, will ensure your child grows up understanding the importance of good oral hygiene and proper dental care. Having your child’s first experience with the dentist be a routine checkup, rather than an emergency visit, could also help make his visit more comfortable and less stressful.
How to Get Dental Insurance for Your Kids
You can buy dental insurance for your kids the same way you buy health insurance: through the federal or state Obamacare marketplaces, directly from an insurance company, via an independent marketplace that sells ancillary benefits (like ours), or through a broker or agent who represents one or more dental companies. Unlike with major medical coverage, you can buy a dental plan for your children at any point in the year if you’re buying it outside of an ACA marketplace, meaning privately. And if you do buy a standalone dental plan from an Obamacare exchange – which can only be purchased if you also buy health insurance from the exchange – you can drop that standalone dental plan at any time. If you don’t have dental coverage for your kids now but think you’ll need it, take the time to shop around. Standalone dental plans from private sources don’t typically cost a lot, but you’ll want to compare the benefits and features carefully.
A Note About the Exchanges
The ACA requires health insurance exchanges to make children’s dental coverage available since this benefit is considered essential under the law. Dental coverage must be included in the overall healthcare plan or available as a standalone benefit when you buy a health plan through the marketplace. That doesn’t mean dental health insurance for your child is automatic or free, or even that all plans cost the same and cover the same things. As with any coverage, dental plans will vary based on the company and where you live, not to mention the cost of your health plan itself. Shop around before settling on a plan. Dental coverage for children usually doesn’t cost much, especially if you’re adding it to an existing major medical plan or buying a standalone policy from an independent marketplace.
Understanding the Different Types of Dental Plans
There are three basic types of dental insurance for kids:
- Embedded plans: Dental coverage as part of a healthcare plan is known as an embedded plan. This is healthcare insurance that includes dental benefits as part of the overall coverage package, most commonly for pediatric dental instead of adult.
- Bundled plans: Bundled plans are made up of two separate policies (dental and medical) from the same insurer. Though these plans come from the same insurance company, each plan may have different cost structures for health or dental services. Some insurers offer discounts on the cost of premiums for bundled plans. You can find bundled plans for major medical and short term health insurance.
- Standalone plans: Many insurance companies offer dental plans that are completely separate from your health insurance. These plans, known as standalone policies, may be available from health insurance carriers or a company that specializes in dental coverage. Premium costs and the benefits provided are separate. One difference in a standalone plan is that you may be able to purchase it through a private insurer or independent marketplace at any time, instead of having to wait for the ACA open enrollment period.
What Services are Covered?
Coverage will vary from plan to plan. Most dental plans cover procedures like preventive checkups, x-rays, fillings and tooth extractions, and they typically cover the entire cost of twice-annual checkups without any copayments or coinsurance. More expensive care, such as orthodontic treatments like braces, might not be covered or would be covered at a lower percentage, usually about 50 percent. When considering which plan to purchase, take into account the possible need for future services and choose a plan that covers those services. If you’ve got older kids who might need braces, look for coverage with more generous orthodontic benefits. For younger kids, preventive care is likely all they’ll need.
Expected Out-Of-Pocket Expenses
When it comes to dental insurance for your kids, your premium, deductibles and copays work essentially the same as they do under a health plan. Costs depend on the type and amount of coverage you purchase, and outside of preventive services like a regular cleaning, you’ll need to meet a deductible before the insurer pays its share of your bills. ACA exchange standalone dental plans limit out-of-pocket expenses to $350 for one child or $700 for multiple children on the same plan. Embedded coverage might have dental expenses applied towards the entire healthcare deductible, but the deductible will probably be higher and dental services may only be covered after the deductible is met. Though this is common, preventive dental care for kids is usually still covered regardless of the deductible. Teaching your kids good dental health habits starts long before they can hold a toothbrush. Preventive dental care is critical in maintaining good health, and there are ways to make regular trips to the dentist more affordable. Whether it’s dental coverage through your employer, a private provider or from a plan through the health exchanges, there are cost-effective ways to get the coverage you need for your children.