Pediatric Dental

[Ann H]

In AZ, Humana's plans ON exchange don't have pediatric dental, and OFF exchange automatically do have it at $20 more per person (adults & kids). Go figure. From what I understand, Health Net doesn't require pediatric dental if only adults are covered. I'm not even sure about the other carriers, to tell you the truth. I think it's automatically built into BCBSAZ's plans, because I don't see options with/without it.

So, clearly, carriers are handling it differently.

I would like to know if AZ carriers have that $0 basic kids' dental option that houcoogster is talking about. Sounds like a good idea to me.

 

[taterpeeler]

I have the answer but I'm to busy to explain...

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Boogers smell like pig snot in May

 

[Yagents]

From what I read, it's still subject to deductible, except cleanings. Here is Assurant's:

Child Dental Services benefits are available only to covered persons under 19 years of age. Limited to 1 check up every 6 months. Subject to plan deductible, except Class I: Preventive Dental Services benefits. Non-participating provider Child Dental Services benefits will be considered at the participating provider benefit level for plan deductible and out-of-pocket limit. Non-participating provider benefits are limited to $3,000 per person per calendar year. Plan coinsurance applies for covered services for Class II, III and IV benefits.

 

[FLM2]

From what I read, it's still subject to deductible, except cleanings. Here is Assurant's:

Child Dental Services benefits are available only to covered persons under 19 years of age. Limited to 1 check up every 6 months. Subject to plan deductible, except Class I: Preventive Dental Services benefits. Non-participating provider Child Dental Services benefits will be considered at the participating provider benefit level for plan deductible and out-of-pocket limit. Non-participating provider benefits are limited to $3,000 per person per calendar year. Plan coinsurance applies for covered services for Class II, III and IV benefits.

HSA plans only, copay plans pay 100% preventive, 80% basic, 50% major including orthodontic. Once MOOP is reached, plan pays 100% with no limits in network. According to Assurant, they are using Careington network.

 

[dgoldenz]

One of my clients is applying through HC.gov with subsidy and now it will not lot them go forward with the enrollment unless they select a dental plan. Nice.

 

[houcoogster]

One of my clients is applying through HC.gov with subsidy and now it will not lot them go forward with the enrollment unless they select a dental plan. Nice.

I think I just encountered the same thing so I just printed the app and faxed it in (no subsidy) which is strange because a couple making 33k only the wife applying for coverage and she was American Indian too.

Did it say anything? Did you try and just pick a dental plan to see if it would let you complete it?

 

[Post Quartermaster]

You have got to be kidding. This is the work of whacked out liberals who hate our country and embrace communism.

You know what a commune is, right?

Because I think you're wrong.



This is obviously the work of people who wish for Americans to grow up NOT looking like Great Britain - an island full of people with bad teeth......

And since the American Revolution was a violent separation from the British Empire, I hereby deduce that you obviously hate America.

Do you want Americans to look like the British?

Why do you hate America, Xrac?

 

[AllenChicago]

Well, I've searched the forums high and low, called carriers and the exchange, and can't get a straight answer or reference.

I know Pediatric Dental is an EHB. I know carriers are not required to offer it if a stand-alone option is available.

2) Does failure to have compliant Pediatric dental generate a penalty? In what scenarios (have a child, don't have a child, etc.)?

12-18-2014

I've been wondering the same thing recently, because some (most?) of the Web Broker platforms do not have a dental add-on option, and even HC.gov isn't showing them consistently during Special Enrollment Period enrollments. I believe we now have the answer...

"Each child must have minimum essential coverage, or qualify for an exemption for each month in the calendar year. Otherwise, the adult or married couple who can claim the child as a dependent for federal income tax purposes will generally owe a shared responsibility payment for the child."

Source: IRS Q&A #9 at: Questions and Answers on the Individual Shared Responsibility Provision
ac

 

[SamIam]

Let's say you told them you have a dental plan from a different carrier other than the plan you signed up. How does the gov verify that you really have coverage from an outside carrier?

 

[AllenChicago]

Let's say you told them you have a dental plan from a different carrier other than the plan you signed up. How does the gov verify that you really have coverage from an outside carrier?

Sam, it seems that the Government is placing the responsibility for verifying the existence of dental with the carriers. Remember that BCBSIL letter from a couple of weeks back saying that they will be following up with every family with children under age 19 who don't have Pediatric Dental with BCBSIL, to ensure that they really do have a QDP inforce. HHS is making BCBS do this.

Now, when it comes to the IRS and tax filing time, I haven't studied the forms to see how detailed their questioning is. Don't know if the forms ask if the children have Pediatric Dental Coverage, or not.
ac