A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994.
Indiana 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 Indiana exchange include adult or pediatric dental coverage as part of their health plans, so stand-alone dental plans can be purchased on the exchange.
For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $27 to $97 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Indiana in 2022 was $44.15.
If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the health plan has integrated pediatric dental benefits.
The stand-alone pediatric dental plans available in Indiana 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 is no cap on medically necessary pediatric dental benefits.
As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care are guided by the state’s essential health benefits benchmark plan.
The Indiana benchmark plan includes coverage for both basic and major dental services for children.
In 2023, seven insurers offers stand-alone individual/family dental coverage through the health insurance marketplace in Indiana. These are dental plans that are not included with a medical plan and must be purchased separately:
This coverage 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.
There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in Indiana. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Indiana Department of Insurance. If you would like to purchase a non-ACA qualified dental plan, ask a dentist for recommendations or search online.
There are also various dental discount plans available in every state. Dental discount plans are not insurance, but can offer discounted rates at participating dentists. Learn about the differences between dental insurance and dental discount plans.
To find plans in your area, search online for dental discount plans and the state you are looking to buy a plan in.
Medicaid in Indiana does not cover dental services for eligible adults. Children eligible for Medicaid in Indiana have several programs to enroll in which can offer dental care.
Indiana’s CHIP falls under Hoosier Healthwise, and provides coverage to children and pregnant women with income above the eligibility limits for Medicaid.
For 2022, Anthem's coverage area has increased to 45 counties, and US Health & Life has joined the marketplace, bringing carrier participation to four. Average rates for 2022 amount to an overall decrease of 1.65%.
Indiana expanded Medicaid eligibility through the Affordable Care Act after receiving approval of its HIP 2.0 plan. More than 690,000 people have enrolled, and enrollment has grown significantly during the COVID-19 pandemic. Indiana had been phasing in a work requirement for Medicaid expansion enrollees, but suspended it in the fall of 2019. The Biden administration revoked approval for the work requirement in mid-2021.
For all information on Medicare in Indiana, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
