Pediatric Dental Insurance
February 10, 2021
The Affordable Care Act (ACA) says that all children under the age of 19 are entitled to basic dental care. In fact, pediatric dental insurance is one of the ACA’s 10 essential benefits that must be included in all marketplace plans.
Children should see their dentist regularly to make sure their teeth and gums stay healthy. Pediatric dental insurance helps pay the cost.
Most plans cover preventive services like cleanings and X-rays. Many also cover fillings and other types of dental care when kids see an in-network dentist. Some plans may have annual deductibles plus copays and coinsurance; others might not.
You can buy pediatric dental insurance in one of two ways: separately or as part of a medical insurance plan. Many insurance companies include pediatric dental coverage as part of their medical plans, while others offer stand-alone policies. It pays to shop around to get the benefits you want at the best price.
You may be able to use some of your tax credits to buy a stand-alone dental plan.
If you have any leftover tax credits after paying for your medical insurance, you can use them to buy a separate dental plan if children’s care is included in the plan and your medical insurance doesn’t already include children’s dental benefits. If you buy a separate dental plan, the ACA limits what you’ll have to pay out of pocket for in-network dental care.
Cost-sharing and deductibles vary among plans, but any federal marketplace plan you buy will cap your out-of-pocket costs for pediatric dental at $700 per child ($1,400 per family) per year. State marketplaces may differ, but in general, they limit out-of-pocket costs to no more than $1,000. If dental coverage is part of your medical plan, you may have to meet your full medical deductible before your insurance company starts sharing the costs.
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