When the Affordable Care Act and dental insurance collide
Everyone pays for those mandatory, embedded coverages, even if they don’t need them. Obamacare is insurance, and one of the ideas behind insurance is to share costs among a broad group of people.
Roughly two-thirds of cancer survivors do not have enough household income to cover treatment-related expenses.
But when it passed the Affordable Care Act, Congress decided pediatric dental care would be handled differently. The law permits pediatric dental to be sold separately, like adult dental insurance. Reusch said Congress probably passed the rule to minimize disruption to the traditional dental insurance marketplace.
The law also left it to states to figure out how to provide pediatric dental coverage. So different states have different rules. Some embed pediatric dental in all Obamacare policies, while others mandate that it be sold separately.
It gets worse: Even within state governments, the rules are interpreted in different ways.
In New York, a spokesperson for the state Department of Health said Empire BlueCross is wrong to sell separate pediatric dental coverage to childless customers like me. But another agency, the Department of Financial Services, contradicted the Health Department by saying separate pediatric dental policies can be required. Empire says it follows Department of Financial Services rules.
What happened in Colorado was weirder. Under the state’s rules, insurer Delta Dental provides special pediatric dental policies to the childless for a monthly premium of $0.
Colorado insurers can’t charge the childless more than $1.50 per month for separate pediatric dental coverage, “because it is a no-benefit policy,” said a spokesperson for Colorado’s Department of Regulatory Agencies.
Some Colorado insurers embed pediatric dental care in Obamacare policies, while others sell it separately, said Adam Fox of the Colorado Consumer Health Initiative. “It’s left up to the insurers,” he said.
Some states are trying to fix the mess. California will require pediatric dental insurance to be embedded(HIDDEN) in all Obamacare policies next year, and thus will end the practice of selling separate policies to the childless.
Until it’s fixed everywhere, buyer beware.
