Dental Articles for Individuals

Dental Articles for Individuals

What is the "Exchange"?

What is the "exchange"?

Healthcare reform is here, and a lot of people have important questions about how it affects them and what they may need to do to starting January 1, 2014. The simple answer for individuals is that if you currently have a medical plan (either with your employer or an individual policy), you do not need to do anything. For individuals who do not currently have medical insurance, the individual mandate will require you to purchase insurance for yourself (and dependents) or pay a tax (the insurance mandate only applies to medical insurance, not dental insurance. You are not required by law to have dental insurance). But the law is also intended to make buying medical insurance easier, and therefore we have the healthcare exchange.

The healthcare exchange is an online marketplace created to provide the public with individual healthcare plans. The plans on the exchange meet the new standards that healthcare reform requires. Each state is responsible for either creating their own state-run exchange OR being part federal government exchange. On the exchange, you will find medical insurance plans and dental insurance plans offered by private companies that are available in your state. In addition to being a one-stop shop for insurance, the exchange also provides subsidies to make buying medical insurance easier for those with low incomes.

State Exchange Websites (as of 10/15/13):

Federal Health Exchange:

Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, South Carolina, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming

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Three million more children could have dental insurance by 2018

A recent ADA News story on the potential effects of the (ACA) Affordable Care Act on dentistry stated that an estimated 3 million children will gain dental benefits by 2018 through health insurance exchanges, roughly a 5 percent increase over the number of children with private benefits currently. 

Beyond the exchanges, more children will benefit through employer-sponsored dental benefits with dependent coverage, "although the number is uncertain at this time," the Association said.  

The law includes pediatric dental coverage in a list of essential health benefits to be provided by small and individual group health plans. The ACA does not address coverage for adult dental benefits. However, some states are looking at adult coverage as a potential optional benefit after the ACA-mandated health benefit exchanges are in place.

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