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Oklahoma uses the federally facilitated health insurance marketplace HealthCare.gov for the sale of certified individual/family dental plans.
Not all insurers who offer medical plans through the Oklahoma 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 $37 to $91 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Oklahoma in 2022 was $41.24.
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 Oklahoma will comply with the ACA’s pediatric dental coverage rules. This means out-of-pocket costs for pediatric dental care can’t 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 the Oklahoma benchmark plan, which does include 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 Oklahoma. 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 Oklahoma. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Oklahoma 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 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.
Adults enrolled in Medicaid in Oklahoma are eligible for limited dental services, which include basic preventive care and extractions. Children enrolled in Medicaid are eligible to receive the same benefits as adults, with the addition of root canals and crowns.
Oklahoma’s CHIP runs in combination with SoonerCare, the state’s Medicaid program, and provides dental coverage to uninsured children and pregnant women with income above the eligibility limits for Medicaid.
In 2017 and 2018, Oklahoma has had just a single insurer — Blue Cross Blue Shield of Oklahoma — offering plans. But seven insurers offer plans for 2023, down from a record-high of eight participating insurers in 2022. Enrollment grew to record highs in each of the last four years, with more than 189,000 people enrolling through Oklahoma's exchange for 2022.
Voters in Oklahoma approved Medicaid expansion on the 2020 primary ballot. The expanded coverage guidelines took effect in July 2021, and enrollment began June 1, 2021. More than 290,000 people have gained coverage under Medicaid expansion in Oklahoma.
For all information on Medicare in Oklahoma, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
