10/29/2018

No changes to Covered California dental plan offerings for 2019

Open enrollment begins Nov. 1

Covered California, the state’s health insurance marketplace for the federal Affordable Care Act, has released the participating dental plans for the 2019 benefit year, maintaining the same dental plans offered for 2018.

Open enrollment for 2019 coverage begins Nov. 1 and ends Jan. 31, 2019. Adults and children may enroll in Covered California’s individual and family plans as an optional benefit. There is no tax penalty for consumers who elect not to enroll in a family dental plan, and financial assistance in the form of a tax credit or subsidy is not available for dental coverage.

There are two dental plan product types available for purchase, contingent on the location of the enrollee: a dental preferred provider option (DPPO) and a dental health maintenance organization (DHMO). CDA has continued to advocate for more than one product type for enrollee selection.
The 2019 individual/family and small-business dental plan offerings are:

Individual/Family Dental Plans:
Access Dental Plan - DHMO
Anthem Blue Cross - DPPO
California Dental Network - DHMO
Delta Dental of California - DHMO, DPPO
Dental Health Services - DHMO
Liberty Dental Plan - DHMO
Premier Access - DPPO

Covered California for Small Business:
California Dental Network - DHMO
Delta Dental of California - DHMO, DPPO
Dental Health Services - DHMO
Liberty Dental Plan - DHMO

Dental coverage for children remains an “essential health benefit” under the Affordable Care Act, and all health plans purchased through Covered California include children’s dental coverage. Children under age 19 are automatically covered by dental benefits that are embedded in health plans purchased through Covered California. The chart offered here shows the corresponding dental plan that will provide benefits to the enrolled child when the enrollee selects a given health plan.

Chart 

The proposed 2019 premiums for embedded, individual and small-business dental coverage were not available at the time of this writing.

What dentists need to know

Confirm participation status: Dentists are encouraged to verify their participation status with the dental plans offered in their area (visit coveredca.com to view the plan offerings in your region) and confirm the reimbursement schedule for treating Covered California enrollees. Dentists should inform patients when scheduling appointments whether they participate as a contracted provider with the patient’s dental plan.

Avoid unwelcome surprises: Dental practices should obtain updated dental plan information from their patients at the time of scheduling and diligently verify the patient’s eligibility and benefits before the patient arrives for his or her visit.

New deductibles/copayments: Many plans’ deductible amounts and frequency limitations reset at the beginning of the calendar year and patient copayment amounts may also shift, which reinforces the importance of verifying patient eligibility and benefits prior to the patient’s arrival for treatment.

CDA member dentists may contact TDIC Sales at 800.733.0633 for assistance with small-business health and dental plan purchasing. Dentists may also contact CDA Public Affairs staff for more information at 800.232.7645.



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New state revenue from the taxation of tobacco products, along with support from legislators and Gov. Jerry Brown, is putting over half a billion dollars toward increased Medi-Cal dental provider reimbursements for 2018-19. The higher reimbursement follows years of activity to improve the Medi-Cal dental program and increase access to oral health care for California’s 13.5 million Medi-Cal members.

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