09/15/2016

Preliminary list of participating Covered California dental plans released


Covered California, California's health insurance marketplace for the federal Affordable Care Act, has released some of the participating dental plans for the 2017 benefit year.

Covered California's open enrollment period for 2017 coverage begins on Nov. 1 and ends Jan. 31, 2017. Both adults and children can enroll in Covered California's family dental plans as an optional benefit. There is no tax penalty for consumers who elect not to enroll in the family dental plan, and no financial assistance (in the form of a tax credit) is available for purchasers of the family dental plan.

There are two dental plan product types available for purchase, depending on the location of the purchaser. These are a dental preferred provider option and a dental health maintenance organization. CDA advocated strongly to ensure patients throughout the state had options in the types of plans offered.

The current list of participating dental plans for 2017 includes:

2017 dental coverage available for individual or family plans

Access Dental Plan DHMO
Anthem Blue Cross DPPO
California Dental Network DHMO
Delta Dental of California DHMO and DPPO
Liberty Dental Plan DHMO
Premier Access DPPO

2017 dental coverage available for small businesses

Access Dental Plan DHMO
California Dental Network DHMO
Delta Dental of California DHMO and DPPO
Liberty Dental Plan DHMO
Premier Access DPPO

At the time of print, the 2017 embedded children's dental plans had not been determined. Details on 2017 embedded plans will be coming in the near future and CDA will keep its members updated as information becomes available.

For more information regarding Covered California's Dental Plan coverage, including the embedded and family dental plans and small business health and dental coverage available through Covered California, visit coveredca.com.

What dentists need to know

Verify participation status: As reported previously, dental plans participating in Covered California have not established separate dental provider networks for the Covered California products they offer. However, dentists are encouraged to verify participation status with the dental plans in their area and confirm the reimbursement fee schedule for treating Covered California enrollees. Dentists should also advise patients when scheduling whether they participate as a contracted provider with the patient's plan.

Avoid unwelcome surprises: Dental practices should do some homework before the patient arrives for his or her visit by obtaining updated dental information at the time of scheduling and diligently verify the patient's eligibility and benefits.

New deductibles/copayments for the year: Many plans' calendar year deductibles and visit frequency limitations were reset. Additionally, some patient plans may have new copayment amounts. This reinforces the importance of checking patient eligibility and benefits before the patient arrives for his or her visit.

  • CDA member dentists can contact TDIC Sales at 800.733.0633, option 1, for assistance with small business health and dental plan purchasing. Dentists may also contact CDA public affairs staff at 800.232.7645 for more information.


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