Getting Dental Coverage Without an Employer in Lawrence County
Lawrence County in southeastern Illinois has a small oil production and agriculture economy centered on Lawrenceville — many residents buy dental coverage on their own.
Without an employer plan, dental coverage is something you arrange yourself. Adult dental care isn’t an essential health benefit under the ACA, so a health plan in Illinois doesn’t have to include it. Lawrence County residents shop for health plans on Get Covered Illinois, and adult dental still has to be bought separately.
What to Look for in a Self-Employed Dental Plan in Lawrence County
Five numbers decide a self-employed dental plan: premium, deductible, annual maximum, waiting periods, and whether your dentist is in the network. The annual maximum, commonly $1,000 to $2,000, is the one people overlook.
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.
Before you choose a plan in Lawrence County, look up your dentist in the plan’s own provider directory and call the office to confirm it is in the specific network the plan uses. Networks change, and a practice can be in one insurer’s network but not another’s.
Dental Insurance as a Business Expense in Illinois
If you’re self-employed, dental premiums for yourself, a spouse and dependents generally count toward the self-employed health insurance deduction, which can’t exceed your business’s net profit, isn’t available for months you could join an employer-subsidized plan, and cuts income tax but not self-employment tax.
If you own more than 2% of an S corporation, the premiums generally have to be paid or reimbursed by the company and included in your W-2 wages before you can take the deduction. A CPA can set that up.
Get Covered Illinois, the state-run exchange in Illinois, sells dental plans alongside its health plans during enrollment periods, and its rules decide whether dental can be added on its own. Off the Marketplace, a stand-alone dental plan isn’t tied to Open Enrollment at all. Put your ZIP code in the form below and Daniel will pull the dental plans sold at that address.
Stand-alone dental plans are excepted benefits under federal law, so they don’t count as minimum essential coverage and never stand in for a health plan.
Call (713) 575-9904 and Daniel will send the dental plans sold in Lawrence County and check your provider against each network.