Dental plans find cavities in exchange stats

A first-grader gets a dental checkup at a school in Kansas City, Kan. (AP photo/Charlie Riedel) A first-grader gets a dental checkup at a school in Kansas City, Kan. (AP photo/Charlie Riedel)

Health and Human Services has taken applications for stand-alone dental plan coverage for more than 400, 000 through the public exchange.

About 22 percent of the 421,941 users have SADP coverage or are on track to get it.

But HHS hasn’t yet compiled SADP activity data for the state-based exchanges, and it hasn’t given a complete picture of the dental coverage situation even at the federal exchanges.

HHS has given state-based exchanges permission to choose whether to let participating carriers sell stand-alone dental plans.

If a state-based exchange offers stand-alone dental plans for children, the exchange can let carriers decide whether to cover pediatric dental services. If an exchange shuts out stand-alone dental plans, the plans must cover pediatric dental services.

The federal and state exchanges offer stand-alone dental plans. The typical plans on those exchanges provide no dental benefits. But some exchanges require plans to provide pediatric dental benefits, and some plans on other exchanges also embed the dental benefits.

HHS hasn’t released any dental plan enrollment information for the state-based exchanges, and or on the percentage of plan enrollees getting dental benefits from their plans, according to Evelyn Ireland, executive director of the National Association of Dental Plans.

The Internal Revenue Service says it doesn’t believe PPACA lets it provide the same kind of tax credit subsidy for stand-alone dental premiums that it can provide for plan coverage. Few exchanges are requiring families to buy dental coverage for children enrolling in plan.

Because stand-alone dental coverage is optional, and families have to pay the full market price for the stand-alone plans, only about a quarter of the 86,000 children in enrolling in QHPs have stand-alone plan coverage.

Although dental plan activity figures are incomplete, they show strong consumer demand for adult dental benefits as well as dental plans for children, Ireland says.

Some state-based exchanges won't let dental plans sell stand-alone coverage for adults. Ireland says she's hoping the federal dental activity figures will change attitudes in those states.

“There is a significant opportunity to expand dental coverage for adults as well as children through the offer of adult dental coverage on exchanges,” Ireland says.

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