Dental Coverage for Families in Pope County
Pope County in far southern Illinois is one of the state's most rural counties, bordering the Ohio River near Golconda — a tiny community where many residents buy dental coverage on their own.
Covering a household means covering two groups the ACA treats differently. Adult dental care isn’t an essential health benefit under the ACA, so a health plan in Illinois doesn’t have to include it. Pope County residents shop for health plans on Get Covered Illinois, and adult dental still has to be bought separately.
What Family Dental Plans Cover in Pope 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.
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.
Enrolling Your Family in Dental Coverage in Illinois
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. Outside the Marketplace there is no enrollment window for stand-alone dental, and coverage usually starts the first of the next month. Enter your ZIP code in the form below and Daniel will send you the dental plans available where you live.
If you already need a crown, the waiting period matters more than the premium. HealthCare.gov notes that separate dental plans can have waiting periods for adults, and SecureDental PLUS, for example, waits 12 months for major care and 1 month for basic care.
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 no hospital with emergency services in Pope County itself, so the nearest emergency department may be in a neighboring county.
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 Pope County and check your family’s providers against each network.