How Will the Affordable Care Act Affect Your Access to Dental Care?

As time passes, it seems more and more likely that the hotly contested Affordable Care Act will in fact be put in to action across America in 2014. Commonly called ‘Obamacare,’ the Affordable Care Act aims to provide more affordable health insurance and care to those who previously could not afford it or did not qualify. But what does the ACA mean for dental care?

Currently, it’s estimated that around half of American adults do not have dental insurance. Cost is the major prohibitive factor for most; those who live in rural areas also may not have easy access to an oral care professional.

What’s going to change:

Under the ACA, insurance companies will be required to provide dental care to children; it is estimated that around 8 million previously uninsured children will benefit from additional dental care. This act will also implement programs aiming to educate the general public about proper preventative care and the importance of regular dental checkups and cleanings.

The Affordable Care Act will also focus more funds on providing care to rural or sparsely populated areas, where people are less likely to seek regular checkups due to difficulty in finding a dentist within a reasonable area.

What about coverage for adults?

For adults ineligible for Medicaid without dental coverage, not a lot will change. If you already have some kind of dental insurance, don’t drop it in anticipation of the ACA- while dental care will be required for children, insurers will not be obligated to cover adults. However, individual states will have the ability to provide certain benefits through Medicaid; depending on the state in question, an individual covered under Medicaid may receive no dental coverage, limited to extensive coverage, or emergency dental services only.

Somewhat paradoxically, those who enroll their children in insurance plans provided by their employers may have to pay up to 57% more each month to provide their children with dental care; research by the National Association of Dental Plans suggests many adults will opt to drop their own coverage in order to provide for their children.

Organizations like the ADA, the American Dental Association, are very concerned about the lack of dental care, especially since the medical community is becoming more and more aware of how strongly oral health impacts the rest of the body. Only around 5% of currently uninsured adults are expected to receive dental benefits related to the ACA, while it’s probable that many people will continue to seek ER care for dental issues that could have been prevented with regular dentist visits.

Affordable Dental Care for the Elderly

Caring for your teeth doesn’t become any less important as you get older. Regular checkups and cleanings will help to reduce the risk of serious detail problems at any age. Being able to afford it though shouldn’t be what prevents you from getting what you need. There are dental plans for seniors to help make it possible and affordable.

The number of elderly who haven’t been to a dentist in years is upsetting. When asked, most of them will tell you they don’t have the money to get to see a provider. There are too many other priorities they must spend their money on including housing, food, and medications. A low premium for great dental care can change many things for you.

Compare Plans

Take the time to compare dental plans for seniors as there can be many differences. The prices often vary based on what is included. Some have a lengthy waiting period which means you can’t use the benefits immediately. Others allow you to schedule an appointment and to get the care as soon as you sign up and pay your premium.

Find out about the payments to the dental providers too. Some dental plans for seniors require you to pay it all out of pocket. Then a claim is processed and they will send you a check. It can take a long time to get reimbursed. Realistically, many seniors don’t have the funds to go this route.

The better plans pay the dental provider directly. You will know what your out of pocket costs are going to be in advance. You can budget to pay for them and the insurance coverage will take care of the rest once the dental office has submitted the claim.

Selecting a Provider

If you already have a dentist, find out about the dental plans for seniors they accept. You don’t want to have to change providers due to the coverage you have in place. While you may not have a choice sometimes, check with your current dental office. They will often try to do all they can to get that program approved so they can accept it. They want to keep you as a customer!

If you don’t have a dentist, you can select one of the dental plans for seniors and then find a provider. Before you buy though, make sure they have a long list of great providers you can pick from. Always find out the reputation of any dentist before you schedule an appointment with them. Find out about the types of procedures and methods they offer at that office.

Routine Needs

There are dental plans for seniors that only cover the routine needs. This includes annual exams, x-ray, and a cleaning every six months. These are the most affordable plans. However, you aren’t going to have coverage should you need something more advanced. It is a good idea to have that coverage in place. At some point, most people will need to access those services.

Regular checkups can help you to avoid pain in the mouth and gums. It can help the dentist to recognize signs of problems before they are able to progress. Getting help early on is going to save you money on those more extensive procedures too.

Advanced Dental Care

Coverage for advanced dental care will help you to keep your smile looking great. It will help you to avoid dental problems that will only continue to get worse without successful dental care by a professional. You should look for a plan that will help you to save at least 50% on all of the advanced dental care needs.