hide captionHey, Mom, can I get braces like that guy?
It turns out that readers of all ages — from teenagers to seniors — have questions about the health law. We try to answer the latest batch.
I’m 15 years old, and I really want braces. If my mom signs me up for Obamacare, will it cover it?
It depends. Under the health law, pediatric dental coverage is one of 10 essential health benefits that must be offered to people who shop for plans on the health insurance marketplaces. Depending on the state, dental coverage may be offered on its own rather than as part of a regular health plan. If it is, you wouldn’t necessarily get dental insurance coverage unless your mom buys a standalone plan.
Under the law, plans are required to cover only medically necessary orthodontia, says Colin Reusch, a senior policy analyst at the Children’s Dental Health Project. States or insurers may define medical necessity differently. To determine whether you qualify, a dentist would generally refer you to an orthodontist to evaluate how misaligned your teeth are or whether you have difficulty chewing, for example.
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