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How Dental Insurance Benefits are Affected with Obamacare

With the recent roll-out of the Affordable Care Act otherwise known as Obamacare, there is one industry that is noticeably absent: the field of dentistry. President Obama signed the Patient Protection and Affordable Care Act (ACA) on March 23, 2010. The law is intended to lower the cost of health care and coverage for all Americans and to give more rights to help insured patients. Read about the benefits of the Affordable Care Act as described by the U.S. Department of Health and Human Services. You can learn more about the law regarding coverage, costs and care in the US Department of Health & Human Services web site.

Obamacare is Consistent with American Dental Association (ADA) Policies

  • Increased funding for public health infrastructure, including the Centers for Disease Control and Prevention, oral health programs and national oral health surveillance programs
  • Additional funding for school-based health center facilities  How Dental Insurance Benefits are Affected with Obamacare
  • Increased grant opportunities for general, pediatric or public health dentists
  • Funding for National Health Service Corps loan repayment programs
  • CDC initiation, in consultation with professional oral health organizations, of a five-year national public education campaign focused on oral health prevention and education

How Are Dental Insurance Benefits Affected by Obamacare

The ADA has released resources that catalogue how ACA will affect dentistry: Effects of ACA on Dentistry (pdf).

According to the ADA:

  • About 3 million children are expected to gain some form of dental benefits by 2018 as a result of ACA. Roughly one-third will gain Medicaid dental coverage and two-thirds will gain private dental coverage through health insurance exchanges and employer-sponsored plans. Combined, this will reduce the number of children who lack dental benefits by approximately 55 percent.
  • Nearly 18 million adults will gain some level of dental benefits from the Affordable Care Act, but only 4.5 million of these adults are expected to gain extensive dental benefits through Medicaid. An additional 800,000 are expected to gain private dental benefits through health insurance exchanges. Combined, about 5 percent fewer adults will be without dental benefits. These increases will put pressure on the Medicaid system by generating an additional 10.4 million dental visits each year through Medicaid by 2018.
  • Accountable care organizations could help bridge the gap between oral and general health care, improve coordination of dental care and help reduce overall health care costs. Dental care is not generally included as a core component within today's ACOs, but this is largely due to the current focus on Medicare populations.
  • There is strong evidence that reforming Medicaid and increasing reimbursement rates to market levels would increase access to dental care. The Affordable Care Act does not do enough to address or solve administrative inefficiencies or low dental provider reimbursement levels seen at the state level.

What does this mean?

Under the health care law, dental insurance is treated differently for adults and children 18 and under. Dental coverage for children is an essential health benefit.  This coverage means an improvement on healthcare generally. This means it must be available to you as part of a health plan or as a free-standing plan.

This is not the case for adults. Adults would need to avail of dental insurance as an added policy. As with additional premiums, adults would normally just opt out from this driving up costs further. Dental insurance is affordable now because most policies rarely get maximized let alone utilized. This may be due to fear, anxiety, lack of money for co-payments, or lack of time and interest. With Obamacare, since there will be fewer adults taking advantage of additional dental insurance and those who avail of it would usually require extensive and costly dental procedure, treatment or repair, dental premiums will undoubtedly rise.

Starting in 2014, you must have health coverage or pay a fee. But this is not true for dental coverage. You do not need to have dental coverage to avoid the penalty. (source)

Our Clinic’s Stand on Dental Insurance

At Indianapolis Dentistry, we are insurance friendly and file most insurances but we don’t participate in network insurance plans. We guarantee our work with your simple commitment to maintenance cleaning appointments so you can trust your investment! Learn more about our Warranty Assurance program. We have our written financial policy available for you too.

Use Your Dental Insurance

If you have dental insurance, you should be using your benefits. Even if you don’t need any other dental services, you should always have your regular oral hygiene cleanings to help prevent and detect any early signs of tooth decay, gum disease, oral cancer, or other dental problems.

If you have any questions about insurance, please do not hesitate to call 317-882-0228 and talk to one our staff. We are insurance friendly and would be happy to work with you to discuss what your insurance plan will cover.