A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994.
Minnesota operates a state-run exchange called MNsure for the sale of certified individual/family dental plans.
Not all insurers that offer medical plans through the Minnesota exchange include pediatric dental coverage with their health plans, but stand-alone adult and family plans are available on the exchange.
For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $37 to $99 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Minnesota in 2022 was $42.20.
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 exchange-certified pediatric stand-alone dental plans available in Minnesota 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 Minnesota’s benchmark plan, which does include coverage for both basic and major dental services for children.
Adult and pediatric dental coverage is not automatically included with the medical plans from insurers who offer coverage through Minnesota’s health insurance marketplace.
Some health plans include pediatric coverage, but the majority of plans on the Minnesota exchange do not offer embedded dental coverage.
In 2023, there are three insurers who offer stand-alone individual/family dental coverage through the health insurance marketplace in Minnesota. 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 a variety of dental insurers that sell stand-alone dental plans directly to consumers in Minnesota. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Minnesota Department of Commerce Licensing. 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. Here’s what you need to know 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.
Adults enrolled in Medicaid in Minnesota are eligible for limited preventive dental services. Children can receive more robust benefits if eligible.
MinnesotaCare is a Basic Health Plan which offers coverage outside the exchange for low income Minnesotans. MinnesotaCare does provide non-cosmetic and medically necessary dental services to adults and children.
For children not enrolled in a MinnesotaCare program, Minnesota’s CHIP provides coverage to uninsured children and pregnant women with income above the eligibility limits for Medicaid.
Minnesota's state-run exchange, MNsure, has five carriers offering plans for 2023. Average full-price premiums increased only slightly for 2023, due in part to changes to the state's reinsurance program. American Rescue Plan subsidies are still in effect, making coverage more affordable than it was prior to 2021. Various bills are under consideration in 2023, including measures to add state-funded subsidies and one that would create a public option via a MinnesotaCare buy-in program.
Prior to 2014, Medical Assistance in Minnesota was available to parents with dependent children if their household income was up to 100% of poverty, and to adults without dependent children if their household income was up to 75% of poverty. Eligibility has since been increased to 138% of the poverty level for Medicaid, and the state has also created a Basic Health Program (MinnesotaCare), which covers those with income up to 200% of the poverty level.
More than a million people in Minnesota have Medicare coverage, and 55% are enrolled in private plans (Medicare Advantage or Medicare Cost plans). Minnesota conducts its own standardization for Medigap plans, and has consumer protections in place to ensure access to Medigap plans for disabled beneficiaries under age 65.
