Dental coverage through Access Health CT

Written by Access Health CT | Published November 14th, 2022 | Updated November 14th, 2022

Dental and oral health are important to your overall health and well-being. You can get dental coverage through Access Health CT in a few different ways.

 

All health insurance plans offered through Access Health CT include pediatric dental coverage for anyone under 26 years old. It is also as an Essential Health Benefit under the ACA. Some health plans and programs available through Access Health CT, like the Covered Connecticut Program, include dental coverage for adults. The Husky Health Program (Medicaid/CHIP programs) includes dental coverage for children and adults.

 

If your current health insurance plan doesn’t include dental coverage, you can get a stand-alone dental plan through Access Health CT! You can enroll during the Open Enrollment Period that begins November 1, or during a Special Enrollment Period if you have a Qualifying Life Event.   


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


 

Customers with 2022 stand-alone dental plans can sign in to report changes to their account. Customers can enroll or manage their 2023 dental coverage here.




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

 

  • All health insurance plans available through Access Health CT offer pediatric dental coverage through age 26. Certain medical plans may include some limited adult dental benefits, but these plans do not provide full dental coverage for adults. Stand-alone plans are a great option for people who are over 26 years old and need dental coverage.
  • Financial help does not apply to stand-alone dental plans. If you receive financial help (also called Advanced Premium Tax Credits or APTCs) 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 Period. This includes voluntary termination for not making premium payments, so be sure to pay your monthly bill (premium) to your insurance company.
  • There is no out-of-pocket maximum for adults, some plans have a waiting period before you can start getting covered services, and covered benefits will vary between plans.  Note- there is no waiting period for diagnostic and preventative services. See below for more information.





More About Dental Plans

Plan Benefits & Coverage Areas

  • Adult Dental Coverage – Dental plans have three major coverage areas for adults: Diagnostic & Preventive Services, Basic Restorative Services, and Major Services. Each plan may offer different services and/or coverage, and these differences will have an impact on the monthly cost of your plan. While shopping for plans, consumers can look at the Plan Document to see what services are covered. 
  • Pediatric Dental Coverage – Covered persons up to age 25 can get Dentally Necessary Orthodontic Care in addition to Diagnostic & Preventive Services, Basic Restorative Services, and Major Services. 
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Out-of-Pocket Maximum

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 through age 25. Check your plan details for specific information.

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Benefit Maximum

A Benefit Maximum is a limit on the total amount of covered services under your plan.

Child(ren) dental benefits (for covered persons through age 25) are not subject to a Benefit Maximum. However, there is a Benefit Maximum for adults, age 26 and older. Check your plan details for specific information.  (An “Adult” is defined as a covered person age 26 and older, and a “Child” refers to a covered person through age 26 who would be eligible for pediatric benefits.)

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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, but preventive and diagnostic services do not have waiting periods. You are eligible for coverage 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 26 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.

 

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