Wednesday, November 12
9:00-10:00am MST/10:00-11:00 am CST
The ACA Pediatric Dental Benefit: Issues for Consumer Assisters and Oral Health Stakeholders to Consider
Issues: The separate treatment of dental and medical benefits in federal law and regulations pose a number of challenges to ensure that all children have access to affordable, high quality dental coverage:
1. Stand-alone dental plans are optional to purchase (unless a state requires a dental plan be purchased)
2. Separate insurance policy & premium
3. Separate deductible
4. Separate out-of-pocket maximum
5. Adult coverage may be part of some plans
6. No cost-sharing reductions
7. Some consumer protections may not apply
Training Goals:
1. Equip Navigators, certified application counselors, and other consumer assisters, Primary Care Association (PCA) staff, and State Oral Health Program and oral health advocates with knowledge and tools about the pediatric dental benefit so they can assist consumers with plan selections that are clinically sound and affordable;
2. Raise the awareness of Navigator organizations, PCAs, and State Oral Health Programs and Oral Health Coalitions about the roles they can fulfill:
a. serving as content experts advising consumer assistance personnel and other oral health advocates
b. providing surveillance and feedback to advance an ongoing dialogue in their respective states about issues associated with implementation of the pediatric dental benefit.
Training Topics:
ü Overview of the Pediatric Dental Benefit
ü Marketplace Coverage: Benchmarks, Participating Dental Plans, and Optimal Benefit Design
ü Providing Consumer Assistance in terms of Covered Benefits, Service Limits, and Out‐of‐Pocket Expenses
ü Consumer Protections, Network Adequacy, and Tracking Consumers’ Experiences
http://services.choruscall.com/links/hrsa141112.html
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