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Missouri 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 Missouri exchange include pediatric or adult dental coverage with their health plans, but stand-alone plans are available for purchase.
For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $20 to $94 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Missouri in 2022 was $45.29.
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 Missouri 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 Missouri benchmark plan includes coverage for both basic and major dental services for children.
In 2023, nine insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Missouri. 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 Missouri. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Missouri 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 name of your state.
Missouri recently expanded the dental services available to adults enrolled in Medicaid, although there may be limitations for adults who are not in certain assistance categories. Children can receive comprehensive dental benefits if Medicaid eligible.
MO HealthNet administers Missouri’s CHIP, which provides dental coverage to uninsured children and pregnant women with with income above the eligibility limits for Medicaid.
Missouri's exchange has ten participating insurers for 2023, with the return of UnitedHealthcare (United had previously exited at the end of 2016). Average premiums grew by about 11% for 2023, but premium subsidies also grow to keep pace with the cost of the benchmark plan in each area.
Medicaid expansion took effect in 2021 due to a voter-approved ballot measure. By early 2023, nearly 312,000 people were enrolled in expanded Medicaid. Post-pandemic Medicaid disenrollments resume in Missouri at the end of June 2023, and 200,000 people are expected to be disenrolled from Medicaid over the following 12-month period.
For all information on Medicare in Missouri, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
