Everything Parents Should Know Regarding Dental Insurance for Children

It’s never too early to start considering a dental insurance plan for your children. The American Academy of Pediatric Dentistry (AAPD) recommends that a child visits the dentist by their first birthday or six months after the eruption of their first tooth. Depending on your individual circumstance, the need for dental insurance can practically impose itself – the moment your child gets their first tooth, they can get cavities as well!

You shouldn’t worry though; tooth decay is 100% preventable, and preventative dental treatments are more affordable compared to traditional procedures such as dental fillings, root canals, dental crowns, etc. That said, you can opt for a dental insurance solution that will cover a different range of dental treatments and procedures and is the best fit for your family.

Choosing the right dental insurance plan might sound complicated, but we’re here to help you pick the one that is the best for your family, so we suggest you keep reading.

Dental Insurance for Children and The Affordable Care Act

The Affordable Care Act (ACA) considers pediatric dental coverage for children under 19 to be essential but not obligatory, meaning that parents can choose not to purchase pediatric dental coverage. 

Moreover, ACA is not the only way to obtain a dental care plan for your child. You won’t have to pay penalties should you decide not to enroll your child into this government dental insurance plan. However, this may depend on the state you live in because some states may require that you purchase a standalone dental plan for your child. 

This coverage is available on your state’s marketplace, either as a standalone plan or as a part of a comprehensive health insurance plan. If you choose to buy one of these medical plans for your child, the exchange must also provide you with an option to buy a pediatric dental plan and include it with your plan. The scope of dental coverage dictates the final price  so you as the parent will have to choose the best plan for your children, based on their personal needs,  medical history, and your financial circumstance.

Also, if you happen to buy your medical plan directly from an insurer, they may ask you to offer them “reasonable assurance” that you also will purchase a dental plan for your child. This can vary from state to state and is usually determined by the state insurance regulatory department. 

How to Get Dental Insurance for Your Kids?

Nowadays, you have three options. The first one may be  available through your employer if you have a health plan with them. These plans often come with an option to enroll children in a dental plan. You can speak with an HR representative in your company to learn what kinds of plans they may offer.  

The second option is the Health Insurance Exchange (ACA). These exchanges exist in every state and must offer pediatric dental plans either as a standalone option or as a part of a health plan. The third option is Medicaid or the Children’s Health Insurance Program (CHIP). If you are eligible, these programs can provide free or low-cost dental coverage for your children. Various conditions apply depending on the state you live in, so you will need to get in touch with your state’s agency to find out more about it.

Types of Dental Insurance Plans for Kids

There are three types of dental insurance available, including standalone, embedded, and bundled plans. Standalone plans are usually purchased in addition to a health plan, either through a medical insurance carrier or a standalone dental insurance carrier. If you choose this plan, your premium costs and your benefits will be completely separate from your medical insurance. Embedded plans, on the other hand, are health plans that contain both medical and dental benefits. Numerous employers and exchange plans offer this type of dental coverage for children. Finally, bundled plans are separate medical and dental plans that are obtained through the same insurance carrier and in many cases the billing is aggregated into a single bill. Some insurers offer premium discounts for these plans.

Cost-sharing Features

Dental insurance plans also include cost-sharing features similar to medical plans (think premiums, deductibles, co-insurance, and co-payments). This often depends on the type of plan you purchased and the amount of cost-sharing that is offered. This means that you as a parent should do a thorough investigation to figure out whether the costs of the monthly premiums of medical and dental plans (bundled and standalone) are higher than the cost of a combined (embedded) plan. The same goes for deductibles, co-payments, and other costs.

What Do Dental Insurance Plans for Children Cover?

To summarize, dental insurance plans offered for children will vary by your state, your employer, your insurance company, and the type of plan you might ultimately select. Some plans will even include services such as basic exams and teeth cleaning, preventative dental care treatments such as fluoride treatments, and dental fillings as part of the insurance premium you pay for your policy.