Jessamy Taylor, MPP & Sally Coberly, PhD
Pediatric dental services are among the ten essential benefits that qualified health plans (QHPs) must offer in state and federally facilitated marketplaces created under the Patient Protection and Affordable Care Act (ACA). These benefits may be provided in stand-alone dental plans, as part of a QHP, or bundled with a QHP. The purchase of pediatric dental benefits is not required by the U.S. Department of Health and Human Services, although some states have made purchase mandatory. Concerns have been raised about the affordability of pediatric dental benefits, especially if families are required to pay two premiums and meet separate deductibles and out-of-pocket maximums. This Forum session gave an overview of the pediatric dental benefit, provided a snapshot of the offerings and take up of dental coverage nationally, and highlighted key issues related to the 2014 plan year implementation. Three states shared their experiences implementing the benefit and their plans for 2015.
Children's Dental Health Project, "FAQ: Pediatric Oral Health Services in the Affordable Care Act," March 5, 2014.
Andrew Snyder et al., "Improving Integration of Dental Health Benefits in Health Insurance Marketplaces," National Academy for State Health Policy, April 2014.