Dental Coverage for Families in Franklin County
Franklin County in southern Illinois has a coal-mining heritage and agriculture economy centered on Benton — many residents buy dental coverage on their own.
For a family, the rules differ for the kids and the parents. Health insurance and dental insurance are separate purchases for most adults, because adult dental isn’t an ACA essential health benefit. In Franklin County that means choosing a health plan on Get Covered Illinois first and treating adult dental as its own purchase.
What Family Dental Plans Cover in Franklin County
Under a family dental plan, each person’s claims count against their own deductible until the family cap is reached ($50 per person and $150 per family on SecureDental PLUS), and preventive care generally skips the deductible.
If braces are likely, read the orthodontia terms first: plenty of dental plans leave them out, and SecureDental PLUS limits them to the Premium tier, paying 70% after 12 months up to $500 a year and $1,500 over a lifetime.
Enrolling Your Family in Dental Coverage in Illinois
In Illinois the Marketplace is Get Covered Illinois, which offers dental plans next to its health plans during Open Enrollment and special enrollment periods. Off the Marketplace, a stand-alone dental plan isn’t tied to Open Enrollment at all. Use the ZIP code form below and Daniel will send you the dental options for your address.
Check waiting periods before you buy. HealthCare.gov notes that separate dental plans can have waiting periods before they cover services for adults; on SecureDental PLUS, basic care waits 1 month and major care and orthodontia 12 months, while cleanings have no wait.
A dental plan pays dentists, not emergency rooms. If a tooth infection or a facial injury takes you to an emergency department, that bill goes to your health insurance. Medicare’s hospital directory shows a single emergency department in Franklin County, at Franklin Hospital. One of the county’s hospitals is a critical access hospital, the small rural facilities Medicare designates to keep emergency care close.
A stand-alone dental plan is an excepted benefit: it isn’t minimum essential coverage and doesn’t replace health insurance.
Call (713) 575-9904 and Daniel will send the dental plans sold in Franklin County and check your family’s providers against each network.