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

Is dental coverage an essential health benefit?

Individuals with no coverage | Comparing Plans: Benefits and Costs |
ANSWER

Under the health care law, dental insurance is treated differently for adults and children 18 and under. Dental coverage for children is an essential health benefit. This means it must be available to you, either as a covered benefit under your health plan or as a free-standing plan. This is not the case for adults. Insurers don’t have to offer adult dental coverage. (45 C.F.R. §§ 156.110 and 155.1065.)

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