 Personal Finance PowerPoint Presentation Dental Insurance and Obamacare Prepare to get financially fit by practicing personal finance Remember that insurance is part of our long term risk mitigation strategy where we use the adage of measure twice cut once putting a formal plan in place looking something like setting our insurance goals, developing a plan to reach the goals putting the plan in action, reviewing the results, repeating the process periodically We're looking at dental insurance and Obamacare Most of this information can be found at Investopedia Can I get dental insurance with Obamacare which you can find online Take a look at the references, resources, continue your research from there This is by Andre Blockham, updated December 31, 2021 In prior presentations, we've been talking about insurance in general Moving then to the medical insurance which is more complex in some ways because of the laws and regulations around the medical field and insurance in general and the complexity of the medical field and we note that when we think about the normal kind of insurance with the liability insurance or the property insurance or life insurance we're often trying to safeguard against some event that may be less likely to happen but if it did happen would be quite costly and therefore we want to insure against it from happening that's a little bit different than the medical insurance which does have that capacity to it with the medical insurance because we still might have some big expensive illness that we're trying to safeguard against but they also kind of expanded so that the insurance is often covering as well the routine type of maintenance kind of stuff that would be in the healthcare process The dental insurance is similar to the medical insurance and less similar to like traditional types of insurance where we're typically trying to safeguard against an event that were less likely to happen but which would be financially devastating on the dental insurance type of things we're often times trying to think about can we pay for insurance to mitigate the actual costs of the routine checkups and maintenance kind of stuff and or possibly safeguarding some of that long-term kind of catastrophic event although the caps on insurance are a little bit different than on other medical areas as we've discussed in prior presentations when we're thinking about normal medical insurance you usually have that out-of-pocket cap you don't have that same kind of thing with the dental insurance the dental insurance often having a cap on how much the dental insurance will pay on a yearly basis often times that cap being relatively low compared to costs that could be gathered from dental problems that would be significant okay can I get dental insurance with Obamacare that's the relevant question get into that why don't you okay does Obamacare cover dental insurance the short answer is yes you actually obtain dental coverage through the Patient Protection and Affordable Care Act Obamacare is just a slang term for it you can use the federal health insurance marketplace at healthcare.gov so notice this is a similar kind of process that we talked about with the health insurance so you've got different options for the health insurance and the questions would then be well if there's like a subsidy kind of program for the health insurance often times people might think well I can I apply that same kind of process to the medical insurance which may be more likely to be beneficial for example if certain conditions are met possibly including your income being below a certain threshold so you can use the federal health insurance marketplace at healthcare.gov notice that some states might have their own kind of marketplace so it depends on the state you look at the state you could go to healthcare.gov enter your zip code that might direct you to the state areas if you don't have a state area you might then go to the federal side to find compare dental plans available in your area and enroll in one if you choose generally you will actually go to your own states health insurance marketplace site to enroll so in other words you could start at the healthcare.gov which is kind of like the federal site if you put in your zip code I believe it'll then take you to the relevant state site if you have a relevant state site if not then it might be covered through the federal site some of the general health insurance options available to you may include dental care so if you look at the general health insurance this is often a question that comes up you're saying okay I'm buying health insurance does that cover dental what kind of dental does it cover the normal kind of dental stuff or only like if I got into an accident have reconstructive stuff under the medical side of things so if not you can choose to add a stand-alone dental insurance plan and pay a separate premium for it in any event you must enroll in a health plan to obtain access to a stand-alone dental plan dental plan categories so there are two categories of Obamacare dental insurance plan you've got the high you've got the low the highs and the lows that's what life's about man highs and lows it's all gravy baby the high coverage level has higher premiums but lower co-payments and deductibles and this is the relationship that we would expect between the deductibles and the co-pays and the premiums remember that the deductible represents the amount that you would have to pay for certain services certain dental services before the insurance kind of kicks in so you would expect that if you have a lower deductible that would be less you'd have to pay before the insurance kicks in for certain items and therefore the premiums the amount that you would pay monthly would be higher and vice versa if you had a higher deductible that would be better for the insurance company and therefore they might be able to allow you to pay a lower monthly premiums for it so you'll pay more every month but less when you use dental services the low coverage level has lower premiums and higher co-payments and deductibles so notice if you're thinking about like classical insurance kind of thing where you're trying to safeguard against say a higher bill that might happen but is less likely to happen as opposed to having something that's going to be there for the more routine type of stuff you might try to have your own insurance meaning self-insured savings to cover up to a certain level and then that would clear the deductibles and beyond that the insurance possibly helps you to kick in on the coverage that's more of a classical way of thinking about it obviously as you have more insurance needs or more dental needs going forward you'd be thinking more and more how can I get insurance that's going to be covering the more visits that I'm going to be having throughout the year but note remember the dental insurance is a little bit different in that it doesn't have that out-of-pocket maximum that you kind of have with the medical oftentimes and so therefore you want to think about what's going to be how much will the insurance company cover if you're trying to think of it as safeguarding you against a more high-cost dental year that they could happen for whatever reason so you'll pay less every month but more when you use the dental services when you compare dental plans and the marketplace you'll find details about each plan's costs, co-payments, deductibles and services covered dental coverage for children versus adults so we got differences with regards to some of the laws and whatnot with children versus adults which makes sense because you would think that the children as their mouth is growing would have different possibly more necessity for preventative stuff and getting things right at that point so under the Affordable Care Act dental insurance is treated differently for adults and children 18 and under it is an essential health care benefit for children this means if you're getting health coverage for someone 18 or younger dental coverage must be available for your child either as part of a health plan or as a standalone plan in contrast dental coverage isn't considered an essential health benefit for adults and insurers don't have to offer dental care as part of their health plans though it must be available to you buying it is optional so we have the Affordable Care Act the Patient Protection and Affordable Care Act was signed into law by President Barack Obama in 2010 with the intent to improve health outcomes lower costs and ensure that a larger number of Americans get medical insurance the laws constitutionality has been challenged in courts and congress with conservatives and labor unions among groups seeking its repeal so we've discussed it's an interesting debate with the Affordable Care Act and the legality of it and basically the constitutionality of it and the whole concept of how it could basically provide more care possibly but how it would also do that to lower costs and the debate is can we lower costs can we extend the care coverage and also lower the cost can we extend the coverage without lowering the quality of the medical services as years go forward so we still have a competitive and advancing medical service in terms of just the science around medicine so these are all interesting questions that we've been addressing lately so the law was upheld by the US Supreme Court in June 2021 some of the rules have changed however the annual enrollment period has shrunk and efforts to promote and support the program have tapered off if you want to use healthcare.gov to obtain coverage be sure to find out the dates of the next enrollment period so there's windows that you need to use for the enrollment period so sign up at the proper time signing up for dental insurance if you want dental insurance the health insurance marketplace gives you a way to easily check for options and compare prices if you sign up for a standalone dental plan remember that you'll be billed separately for the coverage how does one get dental coverage through the Affordable Care Act Affordable Care is available and shoppers need to visit the dental information page at healthcare.gov so you go to healthcare.gov start searching around there if you so choose most people get coverage through their own state's affiliated program so you might go to the federal site and kind of put your zip code in there to link you to your state program so you can take a look at it from there do I get dental insurance as a standalone plan separate from regular healthcare so this is what's kind of confusing with dental you're thinking okay I got medical but then dental is that kind of separate or is it linked in and it gets a little bit confusing because what kind of stuff is going to be part of medical that's related to the mouth versus what would be covered under the dental items so maybe some of the general health insurance options available may include dental care if not you can choose to add on a standalone dental insurance plan and pay a separate premium for it either way you must enroll in a health plan to obtain access to a standalone dental plan for which you'll be billed separately what are the two tiers of Obama dental care they tried to make this one easy with a high and a low tier so notice one of the things that we end up seeing when you try to make something kind of a top down type of thing meaning you kind of regulated more and more from like the federal government or the state government the federal even more so is they're going to try to limit the options and the goal of limiting the options typically will be said that it's going to make things easy it'll make life easy but again that's one of the trade-offs that we have to kind of consider when we're thinking about whether we want a top down system or whether we want you know more open up the market-based kind of system is it better to have less of the choices or would it be better to have more choices even though that can be kind of confusing but then you have more people that can possibly have specialty kind of areas so again interesting debate to look at what you think would be the best way to go the high option has higher premiums but lower co-payments and deductibles meaning you pay more every month but less when you use dental services and as you might guess low coverage has lower premiums but higher co-payments and deductibles you'll pay less every month but more when you use dental services what's the bottom line for crying out loud despite numerous efforts to kill it off the ACA the Affordable Care Act service survives and dental care is included so go to the healthcare.gov dental page to find and compare dental plans available in your area and enroll in one if you choose you can check that out do some more research at healthcare.gov