News

Key Issue: Independent Purchase of Dental Benefits on Healthcare.gov

National Association of Dental Plans (NADP) members urged Congressional leaders to push for a technical update of Healthcare.gov to enable the independent purchase of dental plans, leading to expanded coverage opportunities to more consumers during its 2021 virtual Congressional industry fly-in, “NADP Advocacy in Action,” April 27-29.

 “The mission of NADP is to improve consumer access to affordable, quality dental care,” stated Board Chairman Jeremy Hedrick of Careington International. “We commend our members for advancing our mission and representing our industry by participating in the democratic process.”

Independent Purchase

In 65 virtual meetings with Members of Congress, 55 NADP members sought Congressional support in directing the Center for Consumer Information and Insurance Oversight (CCIIO) to implement a technical fix on Healthcare.gov to allow consumers to purchase dental benefits without having to first purchase medical coverage. Currently, there are no statutory limitations preventing CCIIO from implementing independent purchase.  

The original technical design of the Marketplaces linked medical and dental enrollment functions on HealthCare.gov, preventing the independent purchase of dental coverage. The technical design limitations prevent those who have medical coverage through other means including their employer, Medicare, or a pension plan from purchasing dental on the Marketplaces.

Marketplaces allow consumers to comparison shop for certified standalone dental plans (SADPs), which provide vital coverage for oral health services. Individuals and families are more likely to visit the dentist and seek critical preventive services, such as cleanings, when they have dental coverage. Preventive dental care reduces the likelihood of emergency room visits for treatment of abscesses and cavities, reducing the burden on hospitals challenged by COVID-19 or other community needs. And, preventive dental care reduces the need for more expensive dental procedures and costly medical complications, holding down health care costs.

Several States-Based Marketplaces currently allow for the independent purchase of stand-alone dental plans. State health officials have cited the ability to purchase dental-only coverage on the marketplaces as an important means for the expansion of dental coverage in their state.

Additional Issues

NADP members will also highlight additional topics impacting consumers’ access to dental benefits and care such as dental benefit options for Medicare beneficiaries and maintaining consumer protections offered in dental plans.

 

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