Insurance question: dental and vision

marajay6 · November 2014

DH and I both have jobs that offer dental and vision insurance in addition to our medical plans. It goes without saying that we are adding LO to our medical plan. The question I have is should we add LO to our dental and/or vision plans? It would mean an increase in premium we gave to pay.

jillybean7582 · November 2014

Our health insurance covers dental and eye for minors under 18 automatically. Dental and eye is extra for DH and I but not the kids.

I thought that coverage for minors under 18 was part of the new health reform similar to breast pumps being covered now too because we did not have this coverage when DS was born, it was new this year. (I could be completly wrong on that point as my work switch insurance companies as well so maybe its just part of thos new plan and not part of the health reform)

Anyway worth checking into.....

sweetbabyrahe · November 2014

I'm only adding LO to dental because I already have a family plan and it won't change premiums. I waited a few years after dS1 was born to add him to dental though.

TeeJ526 · November 2014

I'm waiting to add our LO to our dental and vision plans. I figured at best it wouldn't be needed for her until 2016.

jac409 · November 2014

I wouldn't bother with eye for a few years, but you could check with a pediatric dentist to see what a visit costs. If it is less than what it would cost you to add LO to your dental policy, then you might as well wait on that too. You typically don't take them to the dentist until they are around a year old.

PineApple85 · November 2014

I am buying an individual policy for DS2 (long story, it's actually cheaper than putting him on my group plan) and according to the company from which I am buying, dental is required for everyone regardless of age under the ACA or you will still be subject to the "shared responsibility" tax/fine/whatever it is. You'll be charged a pro-rated amount for the rest of this year and, of course, all of next year if you still don't provide dental insurance as of January 1st. Regardless of the lack of teeth.

Kind of like having to pay for maternity coverage on our policies regardless of gender. Good to know that on the off chance that my toothless newborn needs a root canal before giving birth that he'll be covered for both ... and that I'm paying for it whether I want to or not.

I'm happy to be wrong if anyone knows differently. I was told by an insurance broker so it carries a bit of weight in my opinion and I would hate to see someone side-blinded by that one.

ETA: ok, I just googled it and it's required for pediatric plans. The broker I spoke to said that if I put my children on my group (health-only) plan that I do also have to add him to my dental to avoid the penalty though.

PineApple85 · November 2014

Also, be careful of pediatric plans (if you plan to put LO on an individual policy) because I was blindsided by DS1s plan that included dental but the dental had no (literally 0) out of network benefits. It was essentially useless because not only were there very few dentists that would see him before the age of 3, but the ones that would were either OON with his plan (BCBS FL) or they didn't file or contract with any insurance - everyone paid OOP and then filed for reimbursement. I was paying for dental coverage but was gonna have to pay cash regardless so I chose to wait until he is three since there were no apparent dental issues. Not a choice that I was happy to make when I was paying for coverage.

I didn't know that plans existed that had no OON coverage so I never thought to check for it. When I looked closer while shopping for this LO I saw that none of the pediatric plans included OON benefits for the dental coverage. Again, that's BCBS FL and I'm sure every carrier is different but just a heads up to look for it.

PineApple85 · November 2014

Ok, this is the most direct answer I can find to the question but I can't see a date on the page for when it was updated. I'm happy to say that it appears the dental is "required" though not getting it will not subject you to the fine. Kind of hard to require something without consequences but I'll be taking this to the broker selling me my policy.

https://www.healthcare.gov/coverage/dental-coverage/

PineApple85 · November 2014

But then there's this. It's all way too complicated. I'll update after I've obtained some clarification from my insurance guy ...

If the pediatric dental and vision EHB in my state is sold separately, do I have to buy it for my child(ren)?

No. There is no requirement that parents or guardians acquire standalone pediatric dental and vision EHB plans for their dependents, if they buy on their state’s exchange. Those who buy health plans through an employer, as well as those who buy off the exchange, are required to buy the pediatric dental and vision EHB, according to the American Dental Association’s interpretation of the law.

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Insurance question: dental and vision

Re: Insurance question: dental and vision

If the pediatric dental and vision EHB in my state is sold separately, do I have to buy it for my child(ren)?

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