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District of Columbia dental insurance guide 2023

District of Columbia dental insurance guide 2023

DC Health Link has certified individual and family dental plans from four insurers

The District of Columbia uses a district-run health insurance marketplace named DC Health Link for the sale of certified individual/family dental plans.

Not all insurers who offer medical plans through the District of Columbia exchange include dental coverage with their health plans, but stand-alone dental plans are available for purchase that cover both adults and children.

Frequently asked questions about dental coverage in District of Columbia

How much does dental insurance cost in DC?

For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $11 to $51 per month.

IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in DC in 2022 was $43.24.

If a family is purchasing coverage through DC Health Link, the premiums attached with pediatric dental coverage may or may not be canceled out by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the policy has integrated pediatric dental benefits.

Are stand-alone pediatric dental plans on the exchange ACA-compliant?

The pediatric stand-alone dental plans available in the District of Columbia will comply with the ACA’s pediatric dental coverage rules. This means out-of-pocket costs for children’s dental care will not exceed $375 per child in 2023 (or $750 for all the children on a family’s plan), and there is no cap on medically-necessary dental benefits for kids.

As with all essential health benefits, the specific coverage requirements for pediatric dental care are guided by DC’s essential health benefits benchmark plan.

Click here to see details for the District of Columbia’s benchmark plan, which does include coverage for both basic and major dental services for children.

Which insurers offer dental coverage through the DC marketplace?

In 2023, there are four insurers who offer stand-alone individual/family dental coverage through the health insurance marketplace in the District of Columbia. These are dental plans that are not included with a medical plan and must be purchased separately:

  • BEST Life
  • CareFirst BCBS
  • DeltaCare
  • Dominion National

These plans can be purchased through DC Health Link during open enrollment (November 1 to January 31) or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA’s rules for pediatric dental coverage.

Can I buy dental insurance outside of DC's exchange?

There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in the nation’s capital. These plans are not subject to the ACA’s essential health benefit rules for children’s dental coverage, but they are regulated by the DC Department of Insurance, Securities, and Banking. To purchase a non-ACA qualified dental plan, ask a dentist for recommendations or search online.

In DC, there are also various dental discount plans available. Dental discount plans are not dental insurance, but can offer discounted rates at participating dentists. Here’s what you need to know to weigh the differences between dental insurance and dental discount plans.

To find dental discount plans in DC, search online for dental discount plans and the District of Columbia.

How does DC Medicaid and CHIP provide dental coverage?

Adults and children enrolled in DC Medicaid are eligible for comprehensive dental benefits. Adult services are completed through a fee-for-service program.

DC Healthy Families, which is the District of Columbia’s CHIP, provides dental coverage to uninsured children and pregnant women with income above the eligibility limits for Medicaid.

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Individual and Family

District of Columbia health insurance marketplace guide 2023

The District of Columbia has by far the lowest percentage of subsidy-eligible exchange enrollees in the country, for a variety of reasons (although subsidies are now more widely available, due to the American Rescue Plan and Inflation Reduction Act). The District has an individual mandate, does not allow individual or small group plans to be purchased "off-exchange," and has sharply limited short-term health insurance plans. The District has also permanently extended open enrollment so it will run through January 31 each year. The District's COVID special enrollment period for uninsured residents continues through the end of the COVID public health emergency in the District.

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District of Columbia health insurance marketplace guide 2023

Short-term health insurance in Washington, DC

Check short-term health insurance plan availability in DC and shop for coverage. Learn about state regulations regarding short-term plan duration and renewal.

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Short-term health insurance in Washington, DC

Medicaid eligibility and enrollment in DC

The District of Columbia has more generous Medicaid eligibility requirements than most other parts of the country. More than one in three DC residents is covered by Medicaid.

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Medicaid eligibility and enrollment in DC

Medicare in the District of Columbia

For all information on Medicare in the District of Columbia, has you covered. Get all the resources you need to make an informed decision.

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Medicare in the District of Columbia

Learn about health insurance coverage options in your state.

Our state guides offer up-to-date information about ACA-compliant individual and family plans and marketplace enrollment; Medicaid expansion status and Medicaid eligibility; short-term health insurance regulations and short-term plan availability; and Medicare plan options.