What You Need to Know About Dental Insurance for Kids
Posted: September 21, 2022
Receiving good dental care at a young age can prevent cavities and gum disease in kids and give kids a lifetime of bright smiles. Many parents follow best practices for kids’ dental health, such as regular brushing and flossing. Still, these habits may not be enough to prevent every dental condition. Providing dental insurance for your kids is an excellent way to support good oral care and prevent dental issues later in life.
The Affordable Care Act lists dental insurance for kids as one of its 10 essential health benefits, and many plans in the Covered California Health Exchange include this coverage. However, obtaining dental coverage for your entire family requires adding supplemental dental insurance to your family plan or purchasing a stand-alone dental plan.
If you’re looking for California dental insurance for your kids, this guide provides valuable tips and ideas. Discover more critical things to know about California dental insurance for kids!
6 Things You Should Know About Getting Dental Plans for Kids
The top benefit of dental plans for kids is that they help you provide your kids with preventive care and manage its cost. Parents should know a few other things about this kind of coverage before enrolling in California dental plans for children. Here are the top six tips.
1. Start Early
Preventive care gives kids a healthy foundation for life. Regular dentist visits help catch potential issues before they become more severe problems that could be expensive to resolve. Giving your kids good dental care early in life sets them up for a lifetime of healthy teeth. Establishing a dental routine helps kids continue these healthy habits as they age.
As soon as baby teeth start arriving — around age 6 months old, according to the American Dental Association — it’s time to consider getting dental insurance for your child. These baby teeth can develop cavities, so it’s essential to properly care for teeth from the time they come in until your kids get their adult teeth.
The Centers for Disease Control and Prevention recommend taking babies to the dentist as early as their first birthday. Getting dental insurance for your kids before their first dentist visit covers the cost of these visits and provides additional services that benefit them.
2. Consider Group Health Insurance
As mentioned earlier, the ACA requires all health care plans offered in the Marketplace to include pediatric dental services as part of the 10 essential health coverage categories. The regulation applies to individual markets and small group insurance provided through employers with 50 or fewer employees.
Many parents access these dental services for their kids through a family plan their employer offers. If your employer offers insurance, learn about the pediatric dental services it covers by contacting your human resources department.
Even if parents don’t have access to an employer-sponsored plan, they can purchase a family insurance plan to gain this kind of coverage. All Covered California dental plans for California families include children’s dental insurance and cover:
- 50% of major services
- 20% of basic services
- 50% of coinsurance on children’s orthodontics after meeting the deductible
- X-rays, oral exams and tests
- Periodic cleaning and other preventive costs like sealants
These costs count toward the health plan’s maximum out-of-pocket expenses. As an essential health benefit, dental coverage for kids is also subject to the same regulations as the plan’s medical deductible.
3. Look for Adequate Coverage
If purchasing supplemental coverage, parents should look carefully into the kinds of services each plan provides. California insurance for kids varies among health insurance companies, with some plans only covering cleanings. Parents should determine which plan offers the coverage they want for their children. A comprehensive dental plan for kids should include:
- Periodic teeth cleanings
- Dental X-rays and exams to prevent or find potential issues early
- Recognition of any bite issues
- Identification of the possible need for braces
- Emergency dental services for accidents involving teeth or toothaches
- Fluoride treatments for cavity prevention
- Advice on proper brushing, flossing and nutrition
4. Choose Between Two Types of Coverage
Various insurance plans work differently. Parents of kids needing dental coverage should take the time to learn about their options. Dental insurance for kids in California comes in two basic types.
- DMO: A dental maintenance organization is a type of dental coverage from a primary dental physician. These care providers coordinate dental care and can refer patients to specialists as needed. A DMO plan only covers providers from within your network except by referral.
- PPO or PDN: A preferred provider organization or participating dental network plan offers patients more flexibility in seeing providers outside their network. With this plan, patients choose the dentist they want to provide their dental care, and their coverage goes with them.
5. Get Coverage Even Without Insurance
If you’re unsure whether purchasing dental insurance for your kids is the right option for you, you have other options for making their dental care more affordable. These insurance options may not offer the same level of coverage as other dental plans for kids and may have income eligibility requirements.
- Medicaid and CHIP: Medicaid and the Children’s Health Insurance Program offer low-cost or free health insurance for kids up to 19. This coverage includes dental care services like checkups, sealants, fillings and X-rays. Parents can check their family’s eligibility to determine whether this coverage is an option.
- Dental discount plans: Dental discount plans are a membership with an annual fee that allows members to access lower prices on dental services. A dental discount plan isn’t insurance, but it can significantly reduce the cost of visits for those who don’t have coverage.
6. Consider Your Options Carefully
Finding the right dental insurance for kids in California requires planning and consideration. Parents may be interested in balancing the extent of coverage, network providers, deductibles, copays and premiums. Coverage varies among plans and carriers, making thorough research essential.
If you want the benefits of embedded or supplemental dental insurance to gain this coverage for your kids, examine your options to determine what each plan includes. Consider your kids’ ages, dental needs and even family history to determine which coverage options can benefit them the most. It can also be helpful to compare California health insurance companies and their coverage.
Find the Best Dental Insurance for Your Child With Health for California
Obtaining dental coverage for your kids is one of the best ways to boost their dental health at a price you can afford. If you need to sign up for a family plan to access dental coverage for your kids, Health for California can help. Our easy and accurate online application process assists California families with comparing children’s dental insurance plans from insurance companies in California. We make it simple to find the dental care plan that provides the best coverage for you and your family.
When you choose Health for California, our agents offer free guidance in comparing and selecting the most suitable individual and family dental plans. Request a free health insurance quote to start comparing your options. You can also reach out to our representatives today with any questions.