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Kansas 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 Kansas exchange include dental coverage with their health plans, but stand-alone dental plans are available for purchase that cover both adults and children.
For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $39 to $80 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Kansas in 2022 was $42.54.
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 pediatric stand-alone dental plans available on the Kansas 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 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.
You can see details here for Kansas’s benchmark plan, which does include coverage for both basic and major dental services for children.
In 2023, five insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Kansas. These are dental plans that are not included with a medical plan and must be purchased separately:
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.
There are also many dental insurers that will sell stand-alone dental plans directly to consumers in the Sunflower State. These plans will not be subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Kansas Insurance Department. 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 Kansas. It’s important to recognize that dental discount plans are not insurance, but they can offer discounted rates at participating dentists. Here’s what you need to know about the differences between dental insurance and dental discount plans.
To locate the plans available in your area, search online for dental discount plans and the state of Kansas.
Recent legislation has extended dental benefits for adults enrolled in Medicaid in Kansas. Beginning in 2023, adults are now eligible for preventive and restorative treatments. Children continue to receive a full range of dental benefits.
KanCare, which is Kansas’s CHIP, provides coverage to uninsured children and pregnant women with income above the eligibility limits for Medicaid.
The Kansas exchange went from three insurers in 2019 to five in 2020, with the entry of Oscar and Cigna. Blue KC rejoined in 2021, US Health & Life joined for 2022, and UnitedHealthcare rejoined for 2023, bringing total insurer participation to eight. Enrollment hit a new record high in 2023, with more than 124,000 people obtaining coverage during open enrollment.
The Kansas Medicaid program — which is called KanCare — has not been expanded under the ACA. A bipartisan compromise to expand coverage was proposed in 2020, but the legislation was derailed due to unrelated abortion legislation, and did not pass in the 2020 session. Subsequent legislation has also been unsuccessful.
For all information on Medicare in Kansas, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
