ADA: Insurance marketplaces offer more pediatric dental benefits

The medical plans in the U.S. health insurance marketplaces are offering more embedded pediatric and family dental benefits than ever, according to a new research brief by the ADA Health Policy Institute. Since 2014, the plans offering pediatric dental benefits increased nearly 10%, the researchers found.

They evaluated plans in 40 states and found that 35.7% of medical plans have embedded pediatric or family dental benefits. In 2014, only 26.8% of plans offered such benefits.

"Overall, many of the differences observed between the 2014 and 2015 marketplaces are positive from the consumer perspective," the researchers wrote.

They also found that more plans included dental coverage for adults. The researchers likened this to significant interest among young adults to purchase standalone dental plans (SADPs) in 2014.

Other findings in the report include the following:

  • While pediatric dental benefits are an essential health benefit under the Patient Protection and Affordable Care Act, many plans do not offer first-dollar coverage for preventive dental services.
  • Medical plans with embedded dental benefits are more likely to offer first-dollar coverage than standalone plans.
  • Pediatric dental benefits purchased through medical plans are, on average, less costly than purchasing standalone plans.
  • Healthcare.gov, the government's website for federally facilitated marketplaces, is more transparent about dental benefits coverage and cost sharing than it was in 2014.

The researchers concluded the research brief with a note that more research needs to be done.

"As more embedded medical plans are made available to consumers, it will be important to continue studying what, if any, differences there are in accessing dental care via medical plans compared to traditional SADPs," they wrote.

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