Embedded Children’s Dental Coverage
Did you know your children’s dental insurance is already included in your Covered California health plan? The Covered California pediatric dental plan is part of any family health plan you enroll in, regardless of the metal level. So, if you include your kids in your health plan, they’ll also enjoy pediatric dental coverage benefits.
Children’s dental insurance is one of the 10 essential health benefits of the Affordable Care Act (ACA). It’s also included in every Covered California health plan. This pediatric dental benefit takes care of the following:
- Diagnostic costs: Pediatric benefits cover dental services like X-rays, oral examinations and tests.
- Preventive costs: Under the ACA, dental plans should cover preventative services like periodic cleaning and tooth sealants.
- Basic services: Pediatric dental plans must cover 20% of basic services.
- Major services: Pediatric dental plans must cover 50% of major services.
- Orthodontics co-insurance: Under the ACA, pediatric dental plans must offer 50% co-insurance on orthodontics for kids once the deductible for the health plan has been met.
As a part of the essential health benefits of the ACA, dental services for your kids are also subject to the same rules as your medical deductible. They also count towards your maximum out-of-pocket costs for your health plan.
Details About Embedded Children’s Dental Insurance
If you’re looking at dental coverage for children, exploring the details is essential to choosing the right plan that fits your needs. Embedded children’s dental insurance ensures that health care plans offer preventive and diagnostic services for free and are not subject to the stated medical deductible in your health plan.
Embedded dental insurance plans also partly cover the cost of crowns, fillings and root canals. The dental plan and the consumer share the cost, allowing for the even distribution of bills and payments. Embedded plans usually contain no out-of-pocket maximum for your children’s dental costs. However, your out-of-pocket expenses count towards the maximum limit for your health plan.
For many plans, the maximum out-of-pocket amount can range anywhere between $5,000 to $10,000, depending on whether you want a bronze, silver or other health plan. If you choose a Dental Health Maintenance Organization (DHMO) plan, your insurance won’t cover the costs of dental services offered by providers outside the plan’s network. A DHMO health plan requires companies to offer referrals to specialty providers. In most cases, costs for covered dental services differ from the traditional children’s dental plan. Do your research before visiting a dentist to ensure you have the right coverage for your child.
Companies Offering Pediatric Dental Coverage in California
Depending on your chosen health plan, your child will enjoy dental benefits offered by the companies below. Some of the companies also offer separate stand-alone family dental plans. It is essential to research each plan carefully to decide what services they cover may fit your needs. Depending on your child’s dental needs, you may seek a California plan with specific coverage for crowns, fillings or root canals. Here are a few Covered California health insurance plans to consider.
Covered California Health Insurance Plan
Many child dental insurance plans are available in California. If you decide to choose one of these plans, your child will receive many services that may benefit their overall dental health. You can explore various children’s embedded dental plans through Covered California and find the right one for you and your family.
Your child will get dental care benefits from any of the 11 health insurers in California:
- Kaiser Permanente
- Blue Shield
- Anthem Blue Cross
- Oscar Health Plan
- L.A. Care
- Sharp Health Plan
- Valley Health Plan
- Chinese Community
- Molina Healthcare
- Western Health Advantage
- Health Net
Stand-Alone Children’s Dental Insurance Coverage Embedded in Health Insurance
Many health care plans in California offer stand-alone children’s dental insurance coverage embedded in other health insurance plans. Here are a few health insurance companies providing comprehensive dental insurance for your child while embedded within the plan.
- Access Dental Plan (DHMO)
- Anthem Blue Cross (DPPO, DHMO)
- California Dental Network (DHMO)
- Delta Dental of California (DHMO)
- Dental Benefit Providers (DPPO)
- Liberty Dental Plan (DHMO)
Both embedded and stand-alone plans must be part of state exchange benefits programs. Covered California allows you to enjoy the benefits of child dental coverage through any of these programs. Consider looking through Health For California’s services and available dental plans to find one that is right for you.
Get a Quote for Your Child’s Dental Coverage
If you want to know more about pediatric dental insurance or whether you should opt for a stand-alone or embedded pediatric dental plan, Health For California can help you make an informed choice. Call us now to get a detailed quote for each type of plan. We’ll also help you obtain maximum benefits from the dental plan included in the health plan you already have. Request a free dental quote today to learn about which plan to choose.