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  • Dr Shea


People are asking and wondering will the Affordable Care Act (ACA) or “Obamacare” work with or cover dental work? Basically for adults, the answer is “No”.

However, the ACA will cause headaches for the adults, both the adult dental patients and the dental office insurance coordinators. This is due to the ACA requirement that all new medical plans under the ACA include dental coverage as an “essential health benefit”for children through the age of 18.

So, people buying or navigating their way through the ACA sign up and purchase will need to get the dental coverage for their children. Some plans will automatically do this. Some will probably also offer dental coverage for the adults or whole family as well.

BE CAREFUL! If you like your current dentist or want to maintain your right to choose your dentist or whom you feel comfortable working in your mouth, watch out! The dental plans being “sold” are mostly the “Preferred Provider Organization” (PPO) type or what is also referred to as “In-Network.” These plans are “preferred”? Preferred for whom? They are preferred for THE INSURANCE COMPANIES! Why? Because they have dentists under “CONTRACT” to accept what they (the insurance) companies will pay them. The companies often limit what services the dentist will be reimbursed for, so the dentist may not offer the best services available to you, the patient.

Why do dentists sign these contracts? Mostly in hopes of getting new patients in their doors, allowing the insurance companies to pick your dentist for you. That is a shame.

I know many dentists who try to get out of these plans as soon as they can. That should tell you something.


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