As of May 1st, 2014, California healthcare insurance has undergone a significant redesign and restructuring process. Under the name Covered California, it is our state’s implementation of the healthcare marketplace system set fourth by the Affordable Care Act (commonly known as “Obamacare”). Now that open enrollment has ended, many individuals have new and unfamiliar plans and benefits. At Thousand Oaks Family Dentistry, we want to alleviate some of the confusion and alert you as to how Covered California may change your dental coverage. Take a look at these frequently asked questions:
Does my Covered California (CCA) compliant plan include dental coverage?
-For adults over the age of 18, CCA compliant plans do not have to offer any dental coverage. Depending on your provider, dental coverage may be available, but it is strictly on an opt-in basis.
I will be signing up (or signed up) individually through the healthcare marketplace. Does it make sense for me to opt in to dental coverage?
- One thing to consider is that dental insurance is structured differently from medical insurance. While medical insurance includes features such as out-of-pocket maximums and protection against catastrophic accidents, dental coverage is typically a lowered fee schedule in exchange for a monthly premium. It is ultimately your decision if this will be beneficial to your unique needs. Our only advice is that dental plan premiums tend to follow a “get what you pay for” model. Plans with lower monthly payments typically have higher copays and out-of-pocket costs.
Will my children have dental coverage through CCA?
- Children 18 and younger are covered under CCA. However, these dental plans are additional to any insurance plans. You must opt-in or specifically seek out dental coverage for your children. It will typically not be done without your explicit consent or knowledge. Both PPO and HMO options are available, so be aware of what you are signing up for. More information can be found on the Covered California website: https://www.coveredca.com/childrens-dental/
Will the new guidelines set forth by CCA change my experience at Thousand Oaks Family Dentistry?
- The most likely answer is no. Our insurance coverage has not changed as a result of Covered California. In addition, our average patient’s dental coverage has not changed either. If you did not have dental insurance before, you will likely still be uncovered under these new provisions. An exception to this is some children (18 and under) may now be covered under CCA. Again, if this is the case you would likely have been notified by your insurance provider.