Vermont dental insurance guide

For adults who purchase their own stand-alone dental coverage through the exchange in Vermont, premiums in 2025 are $61 per month.³

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.

All stand-alone pediatric dental plans available through Vermont Health Connect (the state-run Marketplace) will comply with the ACA’s pediatric dental coverage rules.

This means the out-of-pocket costs for pediatric dental care on a stand-alone dental plan obtained via Vermont’s health insurance exchange won’t be more than $400 per child in 2024 (or $800 for all the children on a family’s plan),⁴ and there is no cap on medically necessary pediatric dental benefits. (For 2025, the out-of-pocket maximums will increase to $425 and $850, respectively.⁵)

The health plans available through the health insurance marketplace in Vermont include embedded pediatric dental coverage.¹ But they do not include embedded adult dental coverage.²

As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care (either under a stand-alone plan sold through Vermont Health Connect, or embedded in a qualified health plan) are guided by the state’s essential health benefits benchmark plan.

You can see details here for Vermont’s benchmark plan, which includes coverage for both basic and major dental services for children.

In 2025, one insurer offers stand-alone individual/family dental coverage through the health insurance marketplace in Vermont.³ These are dental plans that are not included with a medical plan and must be purchased separately.*

• Northeast Delta Dental

*Plans from insurers may not be offered in all areas.

These plans can be purchased through Vermont Health Connect 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 Vermont. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by Vermont’s 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. 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 and children enrolled in Medicaid in Vermont are eligible for substantial dental services. Adults have an annual cap of $1,000 per calendar year, with preventive services not counting towards that maximum. Medicaid dental benefits in Vermont do not cover cosmetic procedures and only certain elective procedures, which will likely require prior authorization. Children enrolled for Medicaid are eligible to receive the same benefits as adults with no annual cap.

Dr. Dynasaur, Vermont’s CHIP, provides extensive dental coverage to uninsured children and pregnant women with income above the eligibility limits for Medicaid.

• Vermont State Dental Society
• Vermont free or low-cost dental clinics
• Vermont Medicaid
• Vermont Health Connect