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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Pediatric Dental Benefits

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Question: Does Obamacare cover dental until 26 years old?

Answer: Pediatric oral care must be included in all medical insurance offered through the exchanges and small group and individual markets - as mandated by the Essential Health Benefits rule of the ACA. The pediatric dental benefits are imbedded in the qualified health plans. Benefits will include annual check-uo, preventive and diagnostic examination at no cost. Basic dental cost sharing is yet to be determined. Orthodontic care will cover medically necessary services only. There is no clear guidance from HHS yet on how to define pediatrics - such as what age? Stand alone dental plans for adults will continue to be offered on a voluntary basis both within the Exchange and in the outside market to individuals and small groups.

1 Comment

As you point out, there are a few important coverage areas that have yet to be determined under Obamacare. When do you expect to have a definitive answer about pediatric dental coverage?

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