Dental Coverage for Families in Saint Clair County
Saint Clair County is the major Illinois suburb south of St. Louis, home to Scott Air Force Base and a large government and military workforce alongside Belleville's commercial district — military families have Tricare dental while civilian residents often purchase standalone plans.
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. Saint Clair 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 Saint Clair County
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.
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
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. Put your ZIP code in the form below and Daniel will pull the dental plans sold at that address.
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. In Saint Clair County, Medicare’s hospital directory shows three hospitals with emergency departments, among them HSHS St. Elizabeth's Hospital, Memorial Hospital and one other.
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 price the dental plans available at your Saint Clair County ZIP code and check the network for your family.