When the American Dental Association recommends brushing twice a day and flossing regularly, that’s not just for adult. Kids need clean teeth too.
That’s why financial coverage exists. And that’s why the government has programs for those who can’t afford dental insurance.
In this post, we’ll go through the most important aspects of dental insurance for your children.Creative Commons
Dental Insurance For Kids Options
Let’s take a look at some of dental insurance for kids.
Why Children Need Dental Care?
Children need dental coverage just as adults do. Yes, adults may need more preventative or restorative care because they usually consume things like coffee, tea, wine, or smoke cigarettes — all things that can stain and damage teeth.
But kids need clean teeth too. Children usually eat more candy and sugary foods, meaning they need regular cleanings as well.
Sadly, tooth decay is the most common chronic disease in early childhood in the United States. In fact, dental issue cause kids in the U.S. to miss a collective 51 million hours of school each year.
And the cost of the necessary cleanings can be expensive, even if they’re just regular cleanings. This is why kids need dental coverage of some sort, whether it’s insurance or a dental discount plan.
Fortunately, there are lots of options for every child.
Kids Dental Coverage Options
Health insurance companies know that kids need coverage too, so they have programs specifically for them. They can often be more affordable than comparative adult plans and can offer services more specific to children.
But what is the best dental coverage for your kid? Here are your best choices.
Pediatric Dental Insurance Through ACA
Because of the Affordable Care Act (ACA), the federal and state health insurance markets must also offer dental coverage for children (i.e. pediatric dental insurance). So a health insurance plan has to include dental coverage for any children on that plan. And these plans have to cover children until they’re 19 years old.
Now, this doesn’t mean that dental coverage for kids is free, automatic, or that ever plan will cost the same amount. The parent will need to look at the different options and make the best decision for their children and the whole family. And the cost will vary depending on the services covered and the company providing the plan.
The services covered under each plan depends on your state. But most dental plans cover basic diagnostic and preventatitve care, like exams and cleanings. Some plans will even cover 100% of preventative care services, like getting a cavity filled. And orthodontic needs can be covered if they’re “medically necessary,” allowing you to pay less than the average cost of braces.
If you’re looking to get dental coverage for your child through ACA, there are three main ways to do that: through an employer, through the Health Insurance Exchange, or Medicaid/CHIP.
Through your employer. If one of the parents in a household has a health plan through their employer, the plan might include an option for enrolling your child(ren) in a dental care plan. To find out if this is the case, you (or the other parent) can speak with the human resources department of the employer.
Through the Health Insurance Exchange. Each state has their own exchange that’s run by the federal or state government. And they’re required to offer pediatric dental insurance plans, whether on their own or with a health plan.
With Medicaid or Children’s Health Insurance Program (CHIP). Both Medicaid and CHIP are government programs that offer free or very low-cost medical and dental coverage for kids. To qualify, their parents’ income music be below a certain threshold.
These programs are great, but how can you know which one to choose? To help you choose, there are three types of plans you should be familiar with.
- Embedded plans: health plans that offer both medical and dental benefits
- Bundled plans: separate plans — medical and dental — that are offered by the same carrier but with different requirements, premiums, etc.
- Stand-alone plans: a dental plan that is purchased on top of current medical coverage and is separate from that medical coverage
The big question you may be asking is, “How much do these different plans cost? What’s the out-of-pocket expense going to be?”
Well, it’s hard to say. The total cost includes premiums, deductibles, co-insurance, and co-payments. And the overall amount you’ll end up paying out of pocket depends on what type of plan you choose. So the best way to get an idea for the expenses will be to get a quote from a health insurance company (quotes are free and can be done online).
Medicaid & Children’s Health Insurance Program (CHIP)
Medicaid and CHIP have income eligibility requirements and waiting periods, both of which are updated on the Medicaid website.
Generally, these programs cover lawfully residing children, pregnant women, and children of public employees. In every case, beneficiaries of Medicaid and/or CHIP free or low-cost medical and dental coverage.
Dental Discount Plans
Dental discount plans are not insurance, but they can really help pay for the cost of dental coverage.
The way it works is you sign up for a plan online or by phone. Then, once you’re approved (which is guaranteed), you’ll be able to start using the benefits almost right away. When you visit the dentist, you can save up to 60% on every single service. Plans start at just $125 per year, and there are no waiting periods, deductibles, spending limits, or paperwork.
It’s just straight-up savings.
Children need dental care just like adults do. Regardless of age, teeth collect bacteria that needs to be brushed. If not, it can lead to plaque, decay, infections, and cavities.
So, just like adults, children need dental coverage as it can be very expensive. That’s why programs like Pediatric Dental Insurance through the ACA, Medicaid and CHIP, and dental discount plans are super helpful.
Companies like :Dental Plans, Humana, Spirit Dental, and Aetna are leading the charge in children’s dental insurance, seeking to help parents get their kids covered.