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Dental and Vision Coverage

ACA does not mandate dental and vision insurance for adults. For children under age 19, the rules are different. In the exchanges and the individual and small-employer markets, dental and vision insurance are generally required for children under age 19. This requirement does not apply to large employers with 50 or more employees.

Benefits of Using Gifford Insurance

Choosing a health care plan often comes down to cost, but don’t forget to compare the monthly premium with the amount of coverage you get. Our trained professionals will explain and advise you for the best possible results for you and your family.

Common Dental & Vision Questions

The Affordable Care Act requires coverage for pediatric vision care as one of the essential health benefits. The ACA does not require insurers to provide routine vision care coverage for adults.

 

There are 2 categories of Marketplace dental plans: High and low.

  • High coverage level has higher premiums but lower copayments and deductibles. So you'll pay more every month, but less when you get dental services.
  • Low coverage level has lower premiums but higher copayments and deductibles. So you’ll pay less every month, but more when you get dental services.

When you compare dental plans in the Marketplace, you’ll find details about each plan’s costs, copayments, deductibles, and services covered.

  • Dental coverage is an essential health benefit for children. This means if you’re getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a separate dental plan.

    Note: While dental coverage for children must be available to you, you don’t have to buy it.

  • Dental coverage isn't an essential health benefit for adults. Health plans don’t have to offer adult dental coverage.

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