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Georgia dental insurance guide 2023

Georgia dental insurance guide 2023

Georgia's health insurance marketplace has certified individual and family dental plans from seven insurers

Georgia uses the federally facilitated health insurance marketplace HealthCare.gov for the sale of certified individual/family dental plans.

Not all insurers that offer medical plans through the Georgia 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 Georgia

How much does dental insurance cost in Georgia?

For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $22 to $102 per month.

IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Georgia in 2022 was $45.11.

If a family in Georgia is purchasing coverage through HealthCare.gov, the premiums associated with children’s dental coverage may not be covered by premium tax credits (premium subsidies). Here’s more about how that works, and how it depends on whether the health plan has integrated pediatric dental benefits.

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

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

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

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

Which insurers offer dental coverage through the Georgia marketplace?

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

  • BEST Life
  • Humana
  • BCBS of Georgia
  • Dominion National
  • Delta Dental
  • EMI Healthcare
  • DentaQuest

These plans can be purchased through HealthCare.gov during open enrollment (November 1 to January 15) 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 Georgia's exchange?

There are also a variety of dental insurers who sell stand-alone dental plans directly to consumers in the Peach State. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Georgia Office of Insurance and Safety Fire Commissioner. If you would like to purchase a non-ACA qualified dental plan, speak to a dentist for recommendations or search online.

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

To find plans where you live, do an online search for dental discount plans in the state of Georgia.

How does Georgia Medicaid and CHIP provide dental coverage?

Adults enrolled in Medicaid in Georgia are only eligible to receive dental services if it’s a life-threatening situation or conducted in an emergency room, and then only on a case-by-case basis. Children under the age of 21 are eligible for comprehensive dental services through Georgia Medicaid.

PeachCare for Kids (PCK), which is Georgia’s CHIP, provides coverage to children and pregnant women with income above the eligibility limits for Medicaid.

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Here's what you need to know when you're shopping for adult dental coverage through a state health insurance marketplace or directly from a dental plan carrier.
There is no penalty for not having pediatric dental on your policy – and in most exchanges, you can purchase a plan without pediatric dental. But off-exchange, carriers are required ...
If you're an adult who bought a dental insurance plan, your out-of-pocket costs will depend entirely on the amount of dental care you need during the year. But for children, ...
For those who purchase their own insurance, the decision to purchase dental coverage is not always as clear-cut as the decision to purchase health insurance.
Pediatric dental is one of the essential health benefits, although it’s a bit more complicated than the other nine. Some medical policies have pediatric dental embedded in the plan, and ...
Dental insurance and dental discount plans can both be useful in terms of reducing your total dental costs, but they vary significantly in terms of the benefits you get and ...

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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.