Pediatric dental insurance is one of the ten essential benefits that must be included in all ACA Arizona health insurance plans, per federal law. What is never mentioned is how nearly worthless all dental insurance is, including pediatric coverage.
Reading the fine print, most ACA policies dictate that pediatric dental services are subject to the medical deductible, not a separate (and typically much lower) dental deductible found on most stand-alone dental plans in the marketplace. The average ACA annual medical deductible is around $3200. Most children will thankfully never incur thousands of dollars in medical services in a given year, meaning the average child will never receive any benefit from having pediatric dental coverage.
What if a child needs braces or other orthodontic services? Don’t expect the ACA pediatric dental benefit to help out, as most orthodontia services are not covered. There are exceptions of course. If the child’s teeth are misaligned to the point where eating and speaking is difficult, the pediatric dental benefit may be of use… after meeting several thousands of dollars in deductible!
A far better alternative to relying on the ACA pediatric dental benefit, or even a stand-alone dental plan, is to simply place funds into an HSA account on a regular basis for all future dental expenses. (You will need to enroll in an HSA qualified health insurance plan to open a Health Savings Account.) Also, negotiate with the dentist, making sure some discount is applied for paying in cash… cash from your HSA.