Washington (AP) As the Affordable Care Act gets rolled out nationwide, some health care providers say they are scrambling to avoid the pitfalls of the law, including being forced to pay for the cost of care.
Many dentists are already being required to cover the cost for procedures such as filling cavities and teeth.
But the rules aren’t enforced in every state, and dental insurance plans are still being sold without the required cost-sharing.
Some dentists say they’re not confident they’ll be able to find enough dental insurance coverage in their areas to meet the costs, and others worry about the long-term implications of the changes.
If you’re going to have a dental procedure that costs more than $500,000, that’s not covered by insurance and you’re paying for that out of pocket, that makes it difficult to pay the bills, said Dr. Joseph Travaglia, a professor of dentistry at the University of Maryland School of Medicine.
So there’s a huge incentive for providers to look for cheaper, more effective alternatives, said Mark Siegel, president of the American Dental Association.
Some doctors and dentists, though, say they expect more competition from insurers, which have become more aggressive in negotiating lower prices.
If they find a lower-cost provider, they’ll negotiate with them and make a deal that will lower costs, Siegel said.
So what’s the catch?
If you are having a dental surgery and you get a bill that exceeds $500 in the first 30 days, you will not have access to coverage under your dental plan, said Siegel.
You’ll have to get it through a different provider, and you’ll have some flexibility to get your costs down if you want to pay out of your own pocket.
You’re not getting the full benefits of the dental plan that you’re enrolled in, because there are no deductibles or co-payments, said Karen O’Brien, executive director of the National Association of State Dental Officers.
The costs may be lower, but they’re still going to be out of reach for many people.
If your dental costs are a big chunk of your budget, you might want to think about switching providers.
But, if you have coverage through a dental plan you already have and your bills are still out of range, it may be a good idea to get an alternative plan, because you may be eligible for additional subsidies.
If that’s your situation, here are some tips to help you stay healthy and prevent a costly trip to the dentist:If you have a health plan from a major health insurer, you should keep your dental insurance, even if you’re not covered through it.
You may want to ask your insurer if they have dental coverage.
Insurance companies don’t usually reimburse dentists for the expenses of office visits or treatments.
If you have dental insurance through an employer or through a partnership, you may also be able get subsidies from the program.
Insurers may be more likely to cover dental care when they have coverage from a partnership.
The partner typically will cover the costs of a visit, and the insurer may cover some of the costs as well.
If your insurance does cover dental visits, be sure to ask about the coverage of your partner.
In some states, dental insurance may not apply to dental care after a certain point.
But in other states, it doesn’t matter.
So even if your dental coverage ends after a deductible is met, you still should be able use dental insurance.
Insurer deductibles vary widely, and even those deductibles can be quite high.
In some states that don’t have dental insurers, there may be no deductible for dentists who do not provide health care.
If a dental insurance plan has a deductible that exceeds the federal poverty level of $24,000 for a family of four, and your deductible is more than 10 percent of your gross income, you won’t qualify for a subsidy.
If the deductible is less than the federal Poverty level of about $10,000 per year for a household of four and you make more than 50 percent of the federal income limit, you’ll qualify for an amount that’s more than 30 percent of income.
And if you do not have coverage, you could be eligible to get subsidies through the federal Supplemental Nutrition Assistance Program, or SNAP.
To get the money, you must get benefits from a public assistance program and your income is less that 150 percent of poverty.
You will need to have health insurance to qualify for SNAP benefits.
You should be aware that some dental plans offer no deductive or co‑payments or have no limits on the number of visits you can make.
That’s one way to avoid deductibles, Sauer said.