Dental Coverage for Jefferson County Families
Mount Vernon anchors Jefferson County as a regional commercial center for southern Illinois, with healthcare and retail as key employers alongside agriculture — many residents buy dental coverage through an employer or 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. Whatever health plan you pick through Get Covered Illinois, adult dental coverage is a separate decision in Jefferson County.
Adult Dental vs. Pediatric Dental in Jefferson County
Dental care is an essential health benefit for children, so with Marketplace coverage, dental must be available for anyone 18 or younger, either in the health plan or as a separate dental plan. Parents get no such guarantee. Check what your Get Covered Illinois plan already includes for the children before you buy a separate plan for them.
A family dental plan covers each enrolled person under one policy, with the same preventive, basic and major classes of care as an individual plan. Deductibles usually apply per person with a family cap: $50 a person up to $150 a family on SecureDental PLUS.
Choosing a Family Dental Plan in Jefferson County
No website can reliably tell you which dentists in Jefferson County take a particular plan. Offices join and leave networks, so search the plan’s provider directory by the family’s dentists’ name and ZIP code, then call the office to confirm.
Braces are the most common surprise. On SecureDental PLUS they’re covered only on the Premium tier, at 70%, with a 12-month waiting period, a $500 yearly limit and a $1,500 lifetime limit, and many other plans don’t cover them at all.
Waiting periods are the catch. On SecureDental PLUS, cleanings are covered right away, fillings after 1 month, and crowns, bridges and orthodontia after 12 months, and HealthCare.gov warns that separate dental plans in general can have waiting periods for adults.
Serious dental emergencies, such as spreading infection or a broken jaw, are usually treated in a hospital and billed to health insurance rather than the dental plan. Medicare’s hospital directory lists 2 hospitals with emergency services in Jefferson County, including Deaconess Illinois Crossroads and Good Samaritan Regional Hlth Center.
Call (713) 575-9904 and Daniel will price the dental plans available at your Jefferson County ZIP code and check the network for your family.