Colorado Orthodontics

Dental Insurance

Open Enrollment & What It Means for Your Dental Insurance

Open Enrollment is in full swing, and for anyone looking to adopt a new healthcare plan; it means they'll have to make some decisions regarding their dental insurance. We know this can be confusing - with the plethora of laws, plans, and options available to you under the Affordable Care Act, it can be hard to understand what it all means! We want to make the process easier for you, so this blog will give you some overviews and tips for navigating the system and making smart healthcare choices.

An Overview of the ACA's Dental Requirements

While dental insurance isn't required by the ACA, it is offered by many plans and can be purchased as a separate, stand-alone insurance in addition to your normal plan. Dental insurance is designed to cover routine, minor expenses, so plans typically have a maximum around $700-$1400. Keep in mind that this maximum works differently than an out-of-pocket maximum for normal health insurance: once your costs exceed the maximum, you'll pay 100% of costs, as opposed to 0. Many regular health insurance plans cover more serious, expensive procedures like oral or jaw surgery.

For minors (people under 18 years old), dental insurance is mandated by the ACA - so while you don't have to accept it, insurance companies must offer some form of dental insurance. If you choose to reject child dental insurance, you'll still meet the guidelines for minimum essential coverage and won't need to pay a fee.

Another common point of confusion is the accounts that come with some insurance plans - namely, what is the difference between HSAs, HRAs, and FSAs. Here's the breakdown on these accounts:

  • HSA: This stands for Health Savings Account, which is like a 401(k) retirement account for medical expenses, but is only available for HSA-compatible plans. You own this account, and you can contribute to it through untaxed payroll deductions or after-tax, regular contributions. You can use the money to pay for qualified medical expenses, may be able to get a special debit card linked to the account, and can even invest the money in the account!
  • HRA: Health Reimbursement Accounts are set up and funded exclusively by an employer, and they're used to pay for expenses not covered by your regular health plan. Your employer owns the account and contributes a certain amount of money each year, and they decide which expenses qualify for reimbursement.
  • FSA: Flexible Spending Accounts are also set up and owned by your employer, but you get to decide what expenses qualify. These are called "flexible" because they're compatible with most PPO employer-sponsored plans and can pay for expenses even before the account is fully funded.

Dental Insurance: to Insure or Not to Insure

Now the real question: should you get dental insurance or not? This is a decision you'll need to make based on your own values and best judgment, but we always recommend getting it either as part of your regular health insurance plan or as a stand-alone plan. Dental insurance is relatively inexpensive, and it's a great feeling to know you're covered in case anything happens. Ultimately, this is an investment in one of your most important assets: your smile.

Contact Your Denver, CO Orthodontist

Have more questions about navigating Open Enrollment? We're happy to help! Feel free to reach out to us at our Aurora, Denver, or Lakewood, CO office, or use our easy online form to schedule an appointment. We can't wait to hear from you, and we hope to see you back at this blog for more tips and info on keeping your teeth healthy and strong!

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