If there’s one thing everyone knows about looking for health
and dental insurance, it’s that it can be confusing and hard to navigate. The
whole process can be a little stressful whether you’re searching through
private health insurance companies or the Federal Marketplace. Fortunately for
you, this article is going to help you understand the difference between health
and dental insurance and how they work together (or separately) in the Federal
In the Health Insurance Marketplace, you can get federal marketplace dental insurance as
part of a health plan or through a separate, stand-alone plan. If you want it
to be included in your affordable health insurance plan, then you will pay one
monthly premium that includes both the health and dental coverage.
If you want a stand-alone dental plan that’s completely
separate from your health plan, you will have two different monthly premiums
you need to pay. Also be aware that you can’t buy a Marketplace dental plan unless
you’re buying a health plan at the same time.
Marketplace dental plans (whether they’re individual dental
insurance plans or group dental insurance plans) have two categories—high and
low. High coverage plans have higher premiums but lower copayments and
deductibles. Low coverage plans have lower premiums but higher copayments and
deductibles. It’s important to compare dental plans when shopping in the
Marketplace because each plan has different costs, copayments, deductibles, and
What Else Do I Need
to Know When Shopping for Dental Coverage in the Marketplace?
There are a few other important details you need to know
when looking for the best affordable dental insurance in the Federal
Marketplace. For instance, if you’re already enrolled in a Marketplace insurance
plan, you can’t simply add on dental coverage. You have to wait until the next
Open Enrollment Period to change to a plan that includes dental coverage or to
add a stand-alone dental plan.
It’s important to be aware that dental coverage is an
essential health benefit for children 18 or younger. So what does that mean? It
means dental coverage must be available for them as part of a health plan or as
a separate plan. However, while children must have some sort of dental coverage,
adults are not required to buy it.
If you want to cancel your Marketplace dental coverage but
still keep your health coverage, it’s a little bit tricky. With a stand-alone
dental plan, you can cancel your dental plan at any time by not making
payments. This won’t affect your health plan at all because they’re completely
separate. As long as you keep paying for your health plan, you’ll stay enrolled
If you have a health plan that has dental benefits, the only
way to get out of the dental coverage is to wait until Open Enrollment and get
a health plan without dental benefits. Unless you qualify for a Special
Enrollment Period, waiting until Open Enrollment is the only way to get a
stand-alone health or dental plan.
How Do You Use Your
Marketplace Dental Insurance Once You’re Signed Up?
After picking out the right dental plan and getting your
insurance card in the mail, you’re set to go, right? Not quite. There are a few
things you need to do before you stroll into any dentist’s office. Here is a quick
list you can follow if you don’t know what those things are:
sure you know your out-of-pocket costs.
With a high coverage plan, you’ll pay more per
month but you will have lower copays and deductibles.
With a low coverage plan, you have to pay more
when you get to the dentist and use his services, but you’ll pay less each
a dentist that accepts your specific dental plan.
If you go to a dentist that’s out-of-network
(even unknowingly) you’ll always end up paying more, even for basic preventive
care that’s usually 100 percent covered by most plans.
How do you know if a dentist is in-network? You
can search for providers online through your account, you can call your
insurance company, or you can call the dentist office you want to go to.
Always have your insurance card handy so that the
receptionist has all the information she needs to put you into the system as a
what benefits your dental plan includes.
While most dental plans cover basic preventive
care like cleanings every six months, it’s good to check just to make sure.
You’ll want to know if fillings are covered if
you have a cavity.
Some dental plans only cover children while
others cover entire families—that’s why it’s smart to find out exactly what’s
covered before you set up an
Contact EMI Health today if you want to learn more about our Federal Marketplace dental insurance.
Health offers Federal Marketplace dental
insurance suited to your needs. These plans are not only affordable, but they
also cover the basic but important care. In addition to Federal Marketplace
plans, we also provide senior dental plans and a wide variety of health plans. Whatever your need may be
regarding insurance, we’ve got you covered. Contact us today by calling 1-800-662-5851 or by visiting www.emihealth.com.