The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

Can I use a premium tax credit and cost-sharing reductions for a separate dental plan?

Individuals with no coverage | How Premium Tax Credits And Cost-Sharing Reductions Work |
ANSWER

Premium tax credits can be applied to a separate dental plan only when a consumer qualifies for a tax credit larger than the total cost of their health plan premium. In this case, any “leftover” tax credit amount may be applied to the part of the dental plan premium that covers essential health benefits (that is, dental benefits for children, but not for adults). However, because the tax credit is calculated based on the cost of the second-lowest-cost silver plan in a Marketplace, consumers will likely find there is no “leftover” tax credit unless they purchase a very inexpensive Marketplace plan, generally a bronze plan with a very high deductible. Cost-sharing reductions are not available for stand-alone dental plans. (26 U.S.C. § 36B(b)(3)(E); 45 C.F.R. § 156.440.)

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