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Dental Care Available Under ACA

But It Is Unclear What the Impact Will Be on Dentistry

Concord — Deborah Lielasus has an extra reason to smile about the insurance she bought through the online markets created by the federal health overhaul law — new dental coverage.

It took Lielasus three days to sign up for coverage after enrollment opened Tuesday — one day to register, one day to fill out an application and one day to enroll. She and her husband will be paying $874 a month for health insurance — about $550 less than their previous premiums for a plan with fewer benefits. And they added a stand-alone dental plan for $56 a month.

Lielasus, a self-employed grant writer, said she has been putting off routine cleanings, and her husband, who also is self-employed, recently paid out-of-pocket for dental treatment. She was shocked when a question popped up on the federal insurance website asking if she wanted to add dental coverage.

“I had no idea,” she said. “It was a very pleasant surprise.”

Under the nation’s new health care law, dental care is considered an essential benefit for children ages 18 and younger whose parents or guardians get insurance through the individual or small-group plans. The law doesn’t mandate this coverage for adults, but several options are available in New Hampshire through the online marketplace.

Everyone purchasing Anthem Blue Cross and Blue Shield of New Hampshire plans on the marketplace will be offered pediatric dental coverage either as an embedded benefit in a medical plan or through a stand-alone plan. There are no deductibles on the dental products, so dental treatment would not count against the medical deductible, an Anthem spokesman said.

Northeast Delta Dental also is offering four options: two stand-alone pediatric plans and two plans that can be purchased by individuals, families or small groups. Monthly premiums for the Delta Dental plans range from about $30 to $38 a month for children under age 19 and $31 to $43 a month for adults.

According to the National Association of Dental Plans, about 676,600 New Hampshire residents have dental coverage, just over half the population. An additional 58,400 receive some dental benefits through Medicaid.

James Williamson, executive director of the New Hampshire Dental Society, said it’s unclear how much of an impact the new health care law will have on dentistry. His group represents about 80 percent of the state’s dentists, and more than 90 percent of them have the capacity to add patients. But dentists will have to decide whether reimbursement rates through the new plans make it financially feasible, he said, and consumers will have to decide that oral health is important.

Only 54 percent of children covered by Medicaid visited a dentist in 2011, he said, and that figure grew to only 65 percent for those with private insurance.

“Just because you have coverage doesn’t mean you’ll use it,” he said. “There’s lots of efforts going on to educate people, but it’s an ongoing struggle to get people to see that value.”

Both Williamson and an official with Northeast Delta Dental said they are concerned that the overhaul could have a negative effect if parents who get their children covered decide not to purchase coverage for themselves. Jodie Hittle, the insurance company’s vice president of sales and marketing, also said there could be some disruption because those getting new coverage will be required to see network dentists. Overall, however, he doesn’t expect the changes to have a significant impact.

“The resounding sentiment I’m hearing from both the insurance agents is they expect very little enrollment through the exchanges themselves,” he said.