Dental Coverage for Families in Lee County
Dixon anchors Lee County in northwestern Illinois — a manufacturing and agricultural community that also claims Ronald Reagan's hometown, where many residents buy dental coverage through an employer or on their own.
For a family, the rules differ for the kids and the parents. Under the ACA, dental care is an essential health benefit for children but not for adults. Whatever health plan you pick through Get Covered Illinois, adult dental coverage is a separate decision in Lee County.
What Family Dental Plans Cover in Lee 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.
Orthodontia is where family plans differ most. Many exclude braces or cover them only on higher tiers; SecureDental PLUS covers orthodontia only on its Premium tier, at 70% after a 12-month wait, up to $500 a year and $1,500 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. Outside the Marketplace there is no enrollment window for stand-alone dental, and coverage usually starts the first of the next month. Put your ZIP code in the form below and Daniel will pull the dental plans sold at that 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. The only hospital with emergency services that Medicare lists in Lee County is OSF Saint Katharine Medical Center, so check that your health plan includes it.
Keep the category straight: dental insurance is an excepted benefit, not minimum essential coverage, so it sits alongside a health plan rather than replacing one.
Call (713) 575-9904 and Daniel will send the dental plans sold in Lee County and check your family’s providers against each network.