Friday, February 07, 2014

Open Wide ... Take 2

Late last summer, we discussed one of the ObamaTax's "Essential Health Benefits," Pediatric Dental. At the time, we noted that, if nothing else, it represented a major windfall for orthodontists.

Fast forward 6 months or so, and we have this rather uninformed update on how Pediatric Dental coverage is being implemented here in Ohio. As FoIB Holly R tips us:

" other pieces of the Patient Protection and Affordable Care Act, it’s not so simple. That’s because the federal government ruled that dental coverage for kids can be left out of medical plans sold in most states, including Ohio and Indiana."

The author of the piece seems to imply that carriers will use this "loophole" - which is, in fact, specifically encouraged by the ObamaTax itself - to avoid including Pediatric Dental coverage.

Not so fast there, Lisa B-K. Turns out, quite a few carriers continue to offer PediaDent cover:

Anthem requires PD whether or not there are any children actually on the plan, and include a $5.20 charge for this cover regardless. Which seems seems as fair as charging single men and post-menopausal women for birth control convenience items.

Medical Mutual of Ohio says that those with adult only (no children) coverage can waive PD cover, buit those with children are required to enroll. They may, however, unenroll from this cover if they have valid comparable other dental insurance coverage.

Humana's PD coverage, like Anthem's, is "baked into the cake;" that is, it's included whether or not you want it (or need it). Same with United Healthcare/Golden Rule. There is no "opt out" provision, so one is charged for a benefit that one cannot ever use.

How nice.

[Thanks to Kelly V for her clear and concise explanation]
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