Quote and enroll in an ACA health plan during annual open enrollment or a special enrollment period if you qualify.
How Does Dental Insurance Work?
Dental plans typically cover four categories of services: preventive, diagnostic, basic and major care.
The list below includes examples and is not a complete list of coverages, exclusions and limitations.
Individual plans vary, so you’ll want to read the plan details closely to validate the coverage and benefits you’ve selected and limitations and exclusions that apply.
Cleanings + checkups
Extractions
X-rays
Fillings
Crowns, bridges + root canals
Anything after the plan’s annual maximum benefit amount has been reached
Elective cosmetic procedures (e.g., tooth-whitening)
Orthodontics (e.g., braces)
Implants
Prosthodontics (dental prostheses)
Oral care related to a medical condition (e.g., TMJ)
Prescription drugs + analgesia pre-medication
Pediatric services, including oral and vision care, are part of the 10 essential health benefits for children 18 years of age and under. Adults, however, must obtain dental insurance if they want coverage and don’t have it through an employer.
Service | Typical Payment |
Preventive - cleanings and check-ups; fluoride treatments for children | 100% |
Diagnostic* - bitewing x-rays (every 6 months) full-mouth x-rays (every 3 years) | 100%* |
Basic - fillings, extractions | 80% |
Major - root canals, crowns and bridges | 50% |
Speak to a licensed health insurance agent during business hours for help understanding your options and enrolling in coverage.
Footnotes
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