Do Marketplace Health Plans Include Dental Coverage?

Most would consider routine dental care a fundamental human right, as poor dental hygiene can lead to cardiovascular disease, respiratory infections, and even pregnancy complications. With these high stakes at the forefront of your focus, scouring the market for comprehensive health insurance plans with dental coverage should be of utmost importance. 

For those unfamiliar with marketplace health insurance plans, you may be wondering if standard dental coverage is commonplace. Before answering these inquiries, it’s crucial to examine the current state of the healthcare sector.

What is a marketplace health insurance plan?

If you’re a US resident, you’re likely familiar with Obamacare, otherwise known as the Affordable Care Act. By definition, this health care reform law was sponsored by and enacted by US government officials. Unlike other health insurance plans, these ACA-compliant health insurance plans are currently offered through a marketplace health exchange.

Using the exchange, almost 38 US States provide their residents with access to various marketplace health insurance plans overseen by the federal government. On the other hand, 12 US States manage individual health insurance marketplaces.

Regardless of where you reside, the easiest way to view and compare plans on the health exchange marketplace is to visit or the AHiX Marketplace. These platforms can automatically retrieve relevant information about existing health plans in your state.

Do marketplace health plans provide dental coverage?

According to the Affordable Care Act guidelines, every insurance plan on the health insurance marketplace must include dental coverage or offer dental coverage as an optional service. Accordingly, you can select a healthcare plan that may include dental coverage. As a general rule of thumb, expect that these comprehensive health insurance plans will be more costly than those that don’t offer dental coverage.

Another way to get dental coverage is to purchase a stand-alone dental plan offered by a healthcare provider. Since the stand-alone dental plan is optional, you’ll need to pay an additional premium, which isn’t included in the default health insurance plan.

Important considerations

Do you feel inundated by masses of information? If so, here are the most important things to consider when reviewing available health insurance plans:

  • To acquire dental coverage, note that you’ll need to be in possession of some sort of health insurance beforehand. In other words, you can’t secure a stand-alone dental plan without enrolling in a healthcare insurance program.
  • Another critical aspect to consider is the potential wait time for the open enrollment period if you want to add a dental plan to your healthcare insurance coverage. Specific individuals, who are entitled to enroll during a particular enrollment period, can add or even modify their dental plans during this designated period.
  • Dental coverage is treated differently for an adult and minor (those patients under 18-years-old. Since dental treatment is considered an essential healthcare service for children, a health insurance provider must ensure that they present customers with pediatric dental coverage options. The coverage includes preventive and diagnostic care and standard restorative care. In some US States, parents enrolled in a healthcare program must ensure that their children have the necessary dental coverage.
  • You’ll likely pay lower co-payments and a lower deductible in a stand-alone dental plan by paying a higher premium. In contrast, paying a lower premium will force you to pay a higher deductible and a higher co-payment.

Types of dental plans

Hopefully, this overview of marketplace dental plans gifted you with a better understanding of US dental coverage basics. For a review of the dental plans available through marketplace exchange, here’s a summary of each popular dental plan on the market. 

Embedded plans

These dental plans are packaged with a healthcare plan offered by your provider of choice. If your current health insurance policy includes dental coverage, it stands as an example of an embedded health insurance plan. 

Talk to your healthcare provider about the type of dental coverage you and your family will receive, as each healthcare plan offers different services. Should your dental coverage be insufficient, you may need to pay for higher-end treatments.

Bundled plans

The same carrier offers bundled plans. If your healthcare provider offers optional dental coverage, the dental plan will likely be bundled with the default healthcare coverage. The main benefit of a bundled plan is the discount you can benefit from by bundling your health plan and the dental plan.

Stand-alone plan

As the name suggests, a stand-alone dental plan is an individual dental insurance plan. When opting for stand-alone coverage, you’ll likely pay two separate premiums for health insurance and for dental insurance. These stand-alone programs are preferred by individuals who aren’t satisfied with their provider’s current dental coverage. 

Another significant advantage of stand-alone dental coverage is the lack of restrictions when canceling dental coverage. With this added flexibility, beneficiaries can tailor their dental plans to their unique needs and maximize available services. 

In summary

With your pearly whites in tip-top shape, you can avoid certain cancers and respiratory infections triggered by bad oral health. Don’t settle for second best with your marketplace health plan’s dental coverage. Be sure to research the benefits of embedded, bundled, and stand-alone plans to assure you’ve selected a suitable dental plan. 


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Written by Virily Editor

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