While most health insurance plans do not include coverage for routine dental, vision, and hearing care, these are important areas that affect your overall health. How, then, can you get the coverage you need to maintain your quality of life? And how do dental, vision, and hearing insurance plans work when you’re covered under the Affordable Care Act (ACA)?
How to Get Dental Coverage
In the insurance Marketplace, created by the Affordable Care Act, you can get dental coverage in two ways: as part of a health plan, or by itself through a stand-alone plan.
- Some Marketplace health plans include dental coverage. You can see which plans do when you compare them. If the plan includes dental, the premium covers BOTH health and dental benefits.
- In some cases, separate, stand-alone dental plans are offered. You can view them when you shop in the Marketplace. If you select a separate dental plan, you’ll pay an additional premium.
For children up to the age of 19, dental coverage is considered an essential need and must be available through the marketplace. This doesn’t mean that every dental procedure is covered. For example, preventative cleanings may be covered, whereas braces may not. Deductibles and copays may also be required.
For adults, dental coverage is not considered to be essential, meaning that your insurer isn’t required to offer a dental plan for you if you’re over the age of 19. If you’re able to enroll in a dental plan, you can choose between a high premium plan, which will lower the costs of your copays and deductibles, or a low premium plan, which will do the opposite.
How to Get Vision Coverage
Like with dental coverage, vision screenings and necessary corrections to vision are considered essential and required for those under the age of 19. Vision coverage for children is considered to be preventative care under the ACA, and won’t cost you extra.
Unfortunately, also as with dental, vision coverage is not “essential” for adults, meaning an ACA plan is not required to make a vision plan available. It’s possible that certain plans will offer a vision plan, but don’t bank on it.
If no plans in your area cover vision, and you’re in need of vision coverage, there are a couple of ways to go about obtaining it. If you’re employed and receive benefits, vision insurance is often offered. You can also purchase a private, separate vision plan. Depending on your needs, you’ll want to explore what exactly these stand-alone plans include and how high their premiums are.
How to Get Hearing Coverage
For children, hearing coverage is generally considered essential and preventative. However, if a child has hearing loss past the point of 19, they can continue to receive hearing benefits under their parents’ insurance until the age of 26.
For those who are considered deaf or hard-of-hearing, cochlear implants are often covered. This is not a guarantee.
While having insurance through the Marketplace doesn’t guarantee access to comprehensive hearing coverage, there are still parts of hearing health that may be covered. For example, your plan may cover a trip to an ENT, but not necessarily cover a pair of hearing aids.
If you already have chronic hearing problems, you cannot be denied coverage, but it’s important for you to look at plans carefully to see if they offer the benefits you need.
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