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Andriy Blokhin has 5+ years of professional experience in public accounting, personal investing, and as a senior auditor with Ernst & Young.
Updated January 05, 2024 Fact checked by Fact checked by Betsy PetrickBetsy began her career in international finance and it has since grown into a comprehensive approach to journalism as she's been able to tap into that experience along with her time spent in academia and professional services.
Part of the Series Guide to Dental InsuranceChoose the Right Dental Insurance
Dental Insurance Companies
What Does Dental Insurance Cover?
Flexible Spending and Dental Care
Does the Patient Protection and Affordable Care Act cover dental insurance? The short answer is yes. This is done through the Health Insurance Marketplace set up by the Affordable Care Act (ACA), commonly known as Obamacare.
You can use the federal Health Insurance Marketplace at HealthCare.gov to go to your own state's Marketplace to find, compare, and enroll in dental plans in your area. Here is a basic overview of Obamacare coverage for dental insurance.
The Patient Protection and Affordable Care Act was signed into law by then-President Barack Obama in 2010. The law intended to improve health outcomes, lower costs, and ensure that more Americans can obtain medical health insurance.
The law’s constitutionality was challenged in courts and Congress, with conservatives and labor unions seeking to repeal it. The U.S. Supreme Court upheld the law in June 2021.
Despite this, some of the rules have changed. For instance, the annual enrollment period changed, and the tax penalty on uninsured individuals was eliminated. At different times, efforts to promote and support the program have been curtailed and expanded, depending on the priorities and beliefs of the presidential administration. If you want to use HealthCare.gov to obtain coverage, be sure to find out the dates of the next enrollment period.
Some of the general health insurance options available through the Health Insurance Marketplace may include dental care. If not, you can choose to add a stand-alone dental insurance plan. This requires you to pay a separate premium. In any event, you must enroll in a health plan to obtain access to a stand-alone dental plan.
There are two categories of Obamacare dental insurance plans: high and low.
When you compare dental plans in the Marketplace, you’ll find details about each plan’s costs, co-payments, deductibles, and services covered.
You can’t buy a dental plan through the Marketplace unless you’re buying a health plan at the same time.
The ACA treats dental insurance differently for adults vs. children ages 18 and younger.
For children, dental coverage is considered an essential health benefit. This means that if you’re getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan.
For adults, dental coverage isn’t considered an essential health benefit. This means that insurers don’t have to offer dental care as part of their health plans to people over age 18.
If you want dental insurance, the Health Insurance Marketplace provides a way to check options and compare prices. If you sign up for a stand-alone dental plan, remember that you’ll be billed separately for the coverage.
If you wish to cancel your dental insurance for whatever reason (say, if you get a job that gives you coverage), you may be able to do so, depending on the type of coverage. You can cancel your plan anytime if you enrolled for separate coverage. If your Marketplace health insurance plan comes with dental coverage, you cannot opt out of it. You may, however, make changes to your plan so that the new one doesn’t cover dental procedures.
Dental care is available, and shoppers must visit the dental information page at HealthCare.gov. Most people get coverage through their own state’s affiliated program.
No, you cannot buy dental insurance from the Marketplace without buying health insurance. Some of the health insurance options available may include dental insurance. If not, you can choose to add a stand-alone dental insurance plan (and pay a separate premium for it).
Either way, you must enroll in a health plan to obtain access to a stand-alone dental plan, for which you’ll be billed separately.
The Marketplace tried to make this one easy, with a high tier and a low tier. The high option has higher premiums but lower co-payments and deductibles, meaning you pay more monthly but less when using dental services. And, as you might guess, the low coverage has lower premiums but higher co-payments and deductibles. You’ll pay less every month but more when you use dental services.
Despite numerous efforts to kill it off, the ACA survives. This means that dental care is included. So, if you find yourself without dental insurance, you can sign up for it when you need healthcare coverage.
Remember that you can choose a healthcare plan that includes dental coverage, or you may be able to pick a separate plan. Go to HealthCare.gov’s dental page to find and compare dental plans available in your area and enroll in one if you choose.
Article SourcesChoose the Right Dental Insurance
Dental Insurance Companies
What Does Dental Insurance Cover?
Flexible Spending and Dental Care
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Medicare Advantage open enrollment happens every year from January 1 through March 31. Use the time before open enrollment begins to research and compare your options.
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