Department of Health and Human Services seeks comment on dental coverage proposal
Affordable Care Act provisions for pediatric dental services “will improve access to care for consumers who require these benefits,” the administration said in a proposed rule.
Health insurance issuers offering coverage in the individual or small-group market must ensure that coverage includes pediatric dental benefits as an essential health benefit. However, if a stand-alone dental plan is available in the insurance exchanges required by the ACA, qualified health plans offered in the exchange may exclude coverage of the pediatric dental component of the EHB package.
This is the only exception to essential health benefits coverage permitted under the section of the ACA outlining standards for health plans to cover the 10 EHB categories.