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Iowa dental insurance guide
Iowa’s health insurance Marketplace has certified individual and family dental plans from three insurers
Iowa 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 Iowa exchange include pediatric 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 Iowa
How much does dental insurance cost in Iowa?
For adults who purchase their own stand-alone dental coverage through the exchange in Iowa, premiums in May 2024 ranged from about $15 to $61 per month.1
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.
Are stand-alone pediatric dental plans on the exchange ACA-compliant?
The stand-alone pediatric dental plans available in Iowa’s Marketplace (exchange) will comply with the ACA’s pediatric dental coverage rules.
This means out-of-pocket costs for pediatric dental care on a stand-alone plan won’t be more than $400 per child in 2024 (or $800 for all the children on a family’s plan),2 and there is no cap on medically necessary pediatric dental benefits.
If a medical plan has embedded pediatric dental benefits, the maximum out-of-pocket limits described above are not applicable. But since pediatric dental is an essential health benefit, there will be no limit on how much the plan will pay for this care.
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.
You can see details here for the Iowa benchmark plan, which does include coverage for both basic and major dental services for children.
Which insurers offer dental coverage through the Iowa marketplace?
In 2024, three insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Iowa. 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.
Can I buy dental insurance outside of Iowa's exchange?
There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in Iowa. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Iowa Insurance Division. 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.
How does Iowa Medicaid and CHIP provide dental coverage?
Adults eligible for Medicaid in Iowa can enroll in the Dental Wellness Plan, and receive access to extensive dental services. Kids aged 18 and under are eligible to enroll in Dental Wellness Plan Kids.
Hawki, which is Iowa’s CHIP, provides coverage to eligible children and pregnant women with income above the eligibility limits for Medicaid.
What dental resources are available in Iowa?
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- ”See plans & prices” HealthCare.gov. Accessed May, 29, 2024 ⤶
- ”2024 Final Letter to Issuers in the Federally-facilitated Exchanges” Centers for Medicare & Medicaid Services. May 1, 2023 ⤶