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you are > Dental Health Articles > California's plan to separate pediatric dental care from insurance comes under fire

California's plan to separate pediatric dental care from insurance comes under fire
Updated: 7/5/2013 4:14:59 PM


In spite of a federal determination that pediatric dental care is an essential health concern, California's state health insurance exchange has proposed offering children's dental insurance as a separate option from medical health packages.

The move has prompted disagreement over whether that approach will offer parents more options for buying affordable dental coverage or will raise the cost of oral healthcare for children. California Insurance Commissioner Dave Jones opposes selling the benefit as a stand-alone option and has many health advocates on his side.

The federal Affordable Care Act calls pediatric dental services one of the top 10 essential health issues. Jones cited both federal and state laws that are in conflict with the proposal by Covered California, as the state's health insurance exchange is called. Covered California's top official disagreed.

"Covered California is very much following the spirit and intent of both the federal law and all applicable state laws," Peter Lee, the agency's executive director, told the Los Angeles Times. "A lot of the issues around pediatric dental care are complex and confusing. The board has not made any final decisions."

A decision on which way to go must be made before the state's next healthcare insurance enrollment deadline on October 1.

Rising health costs at issue
The public dispute about how pediatric health benefits should be offered to California residents points out the various approaches that the healthcare sector is taking to address rising health costs of dental care.

Discount dental plans for families offer another approach to funding children's oral care that's affordable and provides reduced pricing on a variety of dental services.

The California proposal would make dental coverage optional for children up to age 19 although the federal ACA will require most Americans to buy health insurance starting in January 2014 or pay penalties.

The exchange believes stand-alone dental insurance premiums will be lower for most families - $9 per month for a dental HMO and $35 a month for a PPO plan that allows them more flexibility in choosing their dentists. Jones contended pediatric dental services that are included in overall health insurance plans cost less than purchasing either a stand-alone policy or one that is bundled with a healthcare package.

Several children's advocacy groups also disagree with the stand-alone policy because of the importance of maintaining healthy teeth in children without adding to the cost already faced by parents.

© 2013 Brafton Inc.

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Savings plans are NOT insurance and the savings will vary by provider, plan and zip code. These plans are not considered to be qualified health plans under the Affordable Care Act. Please consult with the respective plan detail page for additional plan terms. The discounts are available through participating healthcare providers only. To check that your provider participates, visit our website or call us. Since there is no paperwork or reimbursement, you must pay for the service at the time it’s provided. You will receive the discount off the provider’s usual and customary fees when you pay. We encourage you to check with your participating provider prior to beginning treatment. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Note – not all plans and offers available in all markets.

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