Pediatric Dental

[steph0216]

Here's my question- if we are quoting on-exchange plans with various carriers (through a WBE or hc.gov) does that pricing include pediatric dental? Or should I be telling families "don't forget to add on $X for you child's dental" depending on what carrier they go with?

I've enrolled several families through Health Sherpa without a choice for a dental plan. Are these families now subject to a penalty? Doesn't make sense. BcbsTX tells me dental is built into all plans, Humana says off exchange have built in dental, on exchange don't.

I'm still a little confused.

 

[RayNY]

Here's my question- if we are quoting on-exchange plans with various carriers (through a WBE or hc.gov) does that pricing include pediatric dental?

I'm still a little confused.

Prepare to stay confused.

You have to track it carrier by carrier. They all handle it differently.

Some embed it. Some make it a "mandatory rider" (I guess to make the premium look better). Some make it an "optional rider". Some don't offer it all but rather refer you to a contracted PED provider who signs you up separately for a compliant plan.

 

[dgoldenz]

On-exchange policies don't have to cover pediatric dental. Off-exchange policies do. Why? Who knows.

 

[AllenChicago]

so you have to call parents and tell them that Obama says they have to have pediatric dental at xx dollars per month for their children or else pay a fine to the Treasury Department for not having it.? should we do that to the affected families? part of the agents overall responsibility?

 

[RayNY]

so you have to call parents and tell them that Obama says they have to have pediatric dental at xx dollars per month for their children or else pay a fine to the Treasury Department for not having it.? should we do that to the affected families? part of the agents overall responsibility?

Why? It's too late to fix this, and it only happens if the client lied to us or didn't pay the PED premium, both are things we don't have a way of knowing.

All apps ask if you have PED. If yes, which carrier? If no, the health carrier sends you what you need to enroll in PED, adds it as a rider, or enrolls you in the PED-inclusive plan.

 

[AllenChicago]

I won't worry about it then. The families who enrolled that do not have pediatric dental did so through Sherpa or by telephone with healthcare.gov.

 

[dgoldenz]

I won't worry about it then. The families who enrolled that do not have pediatric dental did so through Sherpa or by telephone with healthcare.gov.

Exchange policies don't require pediatric dental, so your Sherpa and HC.gov apps should be fine. So I've been told by Anthem anyway....

 

[yankee466]

Exchange policies don't require pediatric dental, so your Sherpa and HC.gov apps should be fine. So I've been told by Anthem anyway....

Agreed...pediatric dental is now a non essential essential benefit for on exchange only. One more adjustment to the law.

 

[Yagents]

Straight from HC.gov:

https://www.healthcare.gov/coverage/dental-coverage/

Adult and child dental insurance in the Marketplace

Under the health care law, dental insurance is treated differently for adults and children 18 and under.

Dental coverage for children is an essential health benefit. This means if you're getting coverage for someone 18 or younger, dental coverage must be available as part of a health plan or as a stand-alone plan. While it must be available to you, you don't have to buy it.

This is not the case for adults. Insurers don't have to offer adult dental coverage.

Under the health care law, most people must have health coverage or pay a fee. But this isn't true for dental coverage. You don't need to have dental coverage, even for children, to avoid the penalty.

 

[AllenChicago]

Straight from HC.gov:
Under the health care law, most people must have health coverage or pay a fee. But this isn't true for dental coverage. You don't need to have dental coverage, even for children, to avoid the penalty.

YAgents, that's a great find, straight from Uncle Sam's mouth.

Re-worded to salesman training lingo..
A family has a Marketplace health plan, but no dental? No problem. They have Minimum Essential Coverage, and avoid the penalty-tax completely!