Getting Dental Coverage Without an Employer in Sangamon County
Sangamon County is home to Illinois's state capital and Abraham Lincoln's home — a large government and healthcare workforce where state employees have solid dental plans but the broader commercial workforce often purchases coverage independently.
Working for yourself means no group dental plan to join. 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 Sangamon County.
What to Look for in a Self-Employed Dental Plan in Sangamon County
Compare dental plans on what they pay, not just what they cost: the annual maximum, the deductible, the waiting periods for basic and major work, and whether your dentist is in the network.
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 Sangamon 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
Self-employed? Dental premiums generally go into the self-employed health insurance deduction on Schedule 1, with the same limits as health premiums: no more than the business’s net profit, no months you were eligible for an employer-subsidized plan, and no reduction in self-employment tax.
More-than-2% S corporation shareholders follow a different route: the company pays or reimburses the premiums and reports them in W-2 wages, and the deduction is then taken personally. Ask your CPA to set it up.
Marketplace dental in Illinois runs through Get Covered Illinois rather than HealthCare.gov, and it is tied to the exchange’s enrollment periods. A stand-alone dental plan bought outside the Marketplace can start in any month, usually on the first of the following month. Put your ZIP code in the form below and Daniel will pull the dental plans sold at that address.
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 send the dental plans sold in Sangamon County and check your provider against each network.