Stand-alone dental coverage offered through Access Health CT

Written by Access Health CT | Published November 3rd, 2021 | Updated November 3rd, 2021


Dental and oral health are important to your health and well-being.  Access Health CT offers stand-alone dental plans you can enroll in during the Open Enrollment Period, or during a Special Enrollment Period if you qualify. A stand-alone dental plan is a dental plan that is separate from your medical health plan. All health insurance plans offered through Access Health CT - including Medicaid/CHIP programs – include pediatric dental coverage as an Essential Health Benefit for anyone under 19 years old.  So, stand-alone dental plans are a great option for people who are over 19 years old and need dental coverage.


To enroll in dental coverage, call us at 1-855-805-4325 or
compare dental options online.  


Current dental customers should sign in to begin or make changes to their account.




Important considerations for stand-alone dental coverage to keep in mind when shopping:

  • All medical plans available through Access Health CT – including Medicaid/CHIP programs – offer pediatric dental coverage for eligible dependents through age 18. Stand-alone plans are a great option for people who are over 19 years old and need dental coverage.

  • There is no out-of-pocket maximum for adult stand-alone dental benefits.  An annual out-of-pocket maximum is the most a member will pay out of their pocket in a coverage year. Adult dental benefits are not subject to an out-of-pocket maximum, so there is no cap on what an adult must pay out of your own pocket. However, there is an out-of-pocket maximum for children under age 19. Check your plan details for specific information.

  • Financial help does not apply to stand-alone dental plans. If you receive financial help or Advanced Premium Tax Credits (APTC) through Access Health CT, that credit cannot be used to help pay for the costs of stand-alone dental plans.

  • If you voluntarily end your dental coverage you may not be eligible to enroll again until the next Open Enrollment PeriodThis includes voluntary termination for not making premium payments so be sure to pay your monthly bill (premium) to your insurance company.



Waiting Periods for New Members

A waiting period is the length of time you must be covered under this policy before you can use your benefits. Certain types of services may have waiting periods under your policy. You are eligible for benefits once your waiting period is over.  Waiting periods only apply to adult benefits as specified within each plan. 


Exceptions to Waiting Periods: Waiting Periods will be waived for newly enrolled adults (age 19 and older) when proof of 12 months of continuous prior coverage for those services is provided from the prior dental insurance carrier and when the termination date is no more than 30 days prior to the effective date of this policy.



Enrollment Status

When you log in to your online account for your Dental coverage, you will see information about your current coverage under Home. More detailed information included below to describe your Enrollment Status. 


Enrollment Status

Explanation

Active

The policy is ‘Active’ with Access Health CT and with the insurance company. 

Inactive

The policy is ‘Inactive,’ due to nonpayment to the insurance company OR termination by Access Health CT. You cannot use your plan benefits while you have this status. 

Pending

The enrollment is in process with Access Health CT but not yet active with the insurance company. You cannot use your plan benefits while you have this status.

Verified

 The policy is active with Access Health CT but not yet active with the insurance company. The carrier hasn’t received your initial premium, and you cannot use your plan benefits while you have this status.

Awaiting Payment

Please contact us immediately. 



More About Plan Benefits

  • An “Adult” is defined as a covered person age 19 and older, and a “Child” refers to a covered person through age 18 who would be eligible for pediatric benefits. 

  • Benefit Maximum (Adult vs. Child): a limit on the total amount of covered services under your plan



Child(ren) dental benefits (for covered persons through age 18) are not subject to a Benefit Maximum. However, there is a Benefit Maximum for adults, age 19 and older. Check your plan details for specific information.  

  • Out-of-Pocket Maximum (Adult vs. Child): the most you have to pay for covered services in a plan year


For covered persons through age 18 (children), there is an annual out of pocket maximum, which is the most a member will pay out of their pocket in a coverage year for Essential Health Benefits before a carrier will pay 100% of the maximum allowed amount for Essential Health BenefitsCheck your plan details for specific information. There is no Out-of-Pocket Maximum for covered persons age 19 and older. 



More Information: