Government Health Insurance Marketplace
The Health Insurance Marketplace is a resource where people, families, and small businesses can:
- Relate health insurance plans for coverage and affordability.
- Get answers to questions regarding your health care insurance.
- Find out if you are qualified for tax credits for private insurance or health programs such as Medicaid or the Children’s Health Insurance Program (CHIP).
- Register in a health insurance plan that meets your requirements.
Can I get dental coverage in the Marketplace?
Yes. You can obtain dental coverage in the Health Insurance Marketplace in two ways:
- Health plans that consist of dental coverage. Dental coverage consists of some Marketplace health plans. You can see which health insurance plans include dental coverage when you compare them.
- If a health plan consists of dental, the premium covers both health and dental coverage.
- Separate, stand-alone dental health insurance plans. In some instances, separate, stand-alone policies are provided. You can see them when you buy plans in the Marketplace.
- If you select a separate dental plan, you will pay a separate, additional premium.
Dental Plan Groups: High and low
There are 2 sets of Marketplace dental plans: High and low.
- The high plan has higher premiums but lower copayments and deductibles. So you will pay more each month, but less when you use dental services.
- The low health insurance level has lower premiums but higher copayments and deductibles. So you will pay less every month, but more when you utilize dental services.
When you compare dental policies in the Marketplace, you will find details regarding each plan’s costs, copayments, deductibles, and services covered.
Adult & Child Dental Plan in the Marketplace
Under the health care law, dental insurance is treated differently for adults and children 18 and below.
- Dental coverage is a crucial health benefit for children. This means if you are getting health coverage for somebody 18 or younger, dental coverage must be available for your kid either as part of a health insurance policy or as a stand-alone plan. Note: While dental coverage for children must be accessible to you, you do not have to purchase it.
- Dental coverage is not an essential health benefit for adults. Health insurance companies don’t have to provide adult dental coverage.
Can I Get an Insurance Plan If I Have a Pre-Existing Condition?
Yes. Under the Affordable Care Act (ACA), health insurance companies cannot decline to cover you or charge you more just since you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage begins. They also cannot charge women more than men.
The only exemption to the pre-existing coverage rule is for grandfathered individual health insurance plans — the type you purchase yourself, not through an employer. They do not have to insure pre-existing conditions.
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