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Health Care Reform:

Health Insurance & Affordable Care Act

Health Reform and Kids' Dental and Vision Care

Dental Benefits for Kids continued...

The benefits in your state and specific plan may be different. Also, your plan may require you to visit an in-network dentist to get these benefits. Make sure you understand what dental care is covered -- and what isn't -- before you buy a plan.

If you qualify, your child may also get dental coverage through programs like Medicaid and CHIP. The kinds of care also vary by state, but in general, they must include services to:

  • Keep your child's teeth healthy
  • Relieve pain or infection
  • Restore teeth

Other Help From the Affordable Care Act

You and your children will get protections from the Affordable Care Act for vision and dental problems:

  • Your children cannot be turned down for coverage because they already have a vision or dental problem.
  • The amount of money you pay out of pocket for care and prescriptions is capped. This means your costs will not go over a certain total each year.
  • Children with a chronic or long-term problem will not have annual or lifetime limits on what insurance will pay.

Vision and Dental Care for Adults

As an adult, you won't get much benefit from the Affordable Care Act when it comes to vision or dental care. The law does not require insurers to extend dental and vision benefits to adults.

Medicare does not cover vision or dental care either. If you have Medicaid, it's up to your state to decide whether vision or dental care for adults will be covered.

Most Marketplaces throughout the country will sell adult and family dental plans. Call or log onto your state’s Marketplace to learn what is available where you live.

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