Obamacare in California has expanded dental coverage in 2015
Covered California Family Dental Plans and Rates
About Covered California’s Family Dental Plans
California families will get expanded opportunities for improved dental health, through Covered California’s offerings of family dental plans.
The plans offer comprehensive coverage for both children and adults.
Purchase of the plans is optional, at an additional cost. Adults can choose to enroll in family dental plans without enrolling the entire family. In the individual exchange, the participating dental carriers are:
- Access Dental Plan.
- Anthem Blue Cross.
- Blue Shield of California.
- Delta Dental of California.
- Dental Health Services.
- Premier Access.
There are two different product types available, depending on where the family lives. The dental preferred provider organization (DPPO) product offers a wide variety of provider choice within a network of participating dentists, as well as coverage for some out-of-network services. The dental health maintenance organization (DHMO) limits coverage to services
provided by a dentist within a network and generally requires a referral to be seen by a specialist.
Covered California family dental plans feature standard co-payments, deductibles and coinsurance requirements. The children’s benefit designs have an actuarial value of 85 percent. An actuarial value is the percentage of total average costs for benefits that a dental plan will cover.
These premiums are for “stand-alone” plans, dental benefit products that can be purchased by themselves to cover a specific service.
Dental plans must follow Covered California standard benefit designs.
Standardizing benefits ensures that the selected plans define what the consumers get and limit the consumer’s out-of-pocket costs.
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