Thursday, August 29, 2013

Open wide and say...Yikes!

One of the "core" elements of the train wreck's Essential Health Benefits mandate is the requirement to provide pediatric dental benefits.

FoIB Jeremy from Assurant Employee Benefits has some news about how that's going to play out in real life. As with so many aspects of the ObamaTax, there's little guidance from Capital City as to what's going to actually be enforced come January. It appears that large groups (ie over 50 employees) probably won't have to make any changes to their plans to remain in compliance.

Small groups, though, will see "pediatric dental EHB services embedded in their medical plan...but those will generally be only dental services for the pediatric population (under age 19)." [ellipses in original]

But what are these services? In general, they'll mirror current coverage available with the SCHIP program, with perhaps some broader coverage available for additional screenings.

But the truly scary part is what's going to happen to the cost of orthodontia.


One of the key "features" of the dental benefit is coverage for "medically necessary orthodontia." But FoIB Fred of Companion Life wonders, since "a definition of medically necessary orthodontia has not been yet established, it is unclear" how many ortho claims will fall in that category?

It's perfectly clear how many such claims will fall under that rubric: 100% of them. Count on it. And, as we have seen in, for example, the higher education, when the government subsidizes something, its cost always skyrockets.

Sounds like the brace-fitters, at least, have reason to rejoice.
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