Mixed Reviews Of Dental Care Under the Affordable Care Act

Published 03/26 2014 06:15PM

Updated 03/26 2014 06:33PM

It is the most common chronic childhood disease.  Now benefits under the Affordable Care Act (ACA) could take a bite out of kids' tooth decay. Pediatric dental care is one of the essential benefits under the ACA. However, some dental workers and patients have a few complaints about the current set up.

Northside Dental Clinic has about 25 patients who can now afford dental care under the ACA.  "We are getting more dental needs met because people are getting that," says Ashley Tackett, dental assistant and front desk worker at Northside Dental Clinic. 

Esther Jo Knirs commented on our Facebook page saying she's saving 320 dollars per month for her family of four.  "I just did today, health and dental. In January we lost the health insurance through my husbands work which we paid $400 a month for, now we pay 80 bucks a month and a 0 deductible for my family of four," writes Esther Jo Knirs.

Ashley Tackett with Northside Dental Clinic says what her average patient pays per month. "They're probably paying on average 147 to 240 dollars for their family coverage,"  says Tackett.

However, dental workers and patients have complaints with the current set up. "We're having to call to verify their insurance.  And we're not getting anyone on the phone.  There's just such a huge calling volume, that we've actually had a patient that had to pay out of pocket," explains Tackett.

That patient is Paulena.  "Finally I just had to give in.  I couldn't wait on it any longer so I just went ahead and self paid,"  says Paulena.

Tackett recommends giving your insurance information to your dentist office well in advance.  Then, be prepared to wait up to two weeks before it is verified and you come for an appointment.

"Some of the plans they're signing up for ... it is only preventative," says Tackett.  That means exams, cleanings, and x-rays are included.  However, major dental work -- such as root canals, crowns and dentures -- is not covered.

People do have the option to get better coverage on a higher level.  "If they're someone who has a lot of issues going on I would definitely recommmend them signing up for a higher level," suggests Tackett.

Even with that higher coverage, Tackett says patients are surprised that they still must wait a year for major work.  "Once they find out the coverage of it is preventative only and there are long waiting periods when they need to have something done now, they're not very happy with it," adds Tackett.

It is estimated up to 8.7 million people age 21 and younger will gain dental coverage nationwide by 2018.  However, dental workers say that people signing up need to be aware of the long waiting periods, and the limitations in coverage.

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