When you transition from an employer-sponsored healthcare plan that offers vision and dental benefits to a Marketplace plan, you might find it surprising that those benefits aren’t also offered with healthcare plans on the Marketplace. Under the Affordable Care Act, dental and vision coverage for adults is not mandated by the ACA. However, dental and vision coverage are considered essential benefits for children under 19. Pediatric dental coverage must be included in the plan or offered as a stand-alone option while pediatric vision coverage must be in included in the plan since there are no stand-alone plan options on the Marketplace.
Stand-alone dental and vision plans may be purchased any time of the year, meaning there is no required open enrollment period, however there may be a waiting period before full benefits can be accessed. However, if you or your dependents are getting dental or vision benefits through a medical plan, you will have to enroll during your state’s Open Enrollment period or a Special Enrollment period if you’re entitled to one.
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If you’re switching to a health insurance plan on the Marketplace, it’s important to consider how you will get vision and dental insurance if this coverage is familiar or important to you. The information in this article will help you make this decision, but you can also reach out to Caribou for assistance in deciding the best option for your health and financial needs.
Last Revised August 8th, 2023