I can't find my old letter from Anthem. That would have been 5 years ago. I did find this.
"Pediatric dental coverage is one of the ten
essential health benefits (EHBs) that the ACA has required on all individual and small group plans since 2014. But section 1302 of the ACA (
see page 61) explains that a policy sold in an exchange without embedded pediatric dental coverage can still be a
qualified health plan (QHP) as long as there is also a stand-alone pediatric dental plan available in the exchange."
Is pediatric dental coverage included in exchange plans?
More.
"But under the
health reform legislation that President Obama signed in 2010, all individual and small group plans effective on or after January 1, 2014 (including plans sold through the exchanges and
outside the exchanges) must include coverage for these ten essential health benefits — EHBs — with no annual or lifetime dollar limit:
- hospitalization
- ambulatory services (visits to doctors and other healthcare professionals and outpatient hospital care)
- emergency services
- maternity and newborn care
- services for those suffering from mental health disorders and problems with substance abuse
- prescription drugs (including brand-name drugs and specialty drugs; the pre-ACA trend towards generic-only coverage was eliminated by the ACA)
- lab tests
- chronic disease management, “well” services and preventive services recommended by the U.S. Preventive Services Task Force (including blood pressure screening, breast cancer screening, colorectal cancer screening, obesity screening and counseling; tobacco use counseling and interventions, and breastfeeding counseling)
- pediatric services for children, including dental and vision care (there is some flexibility on the inclusion of pediatric dental if the plan is purchased within the exchange)
- rehabilitative and “habilitative” services which include helping a person keep, learn or improve functioning for daily living. (Examples include therapy for a child who isn’t walking or talking at the expected age physical and occupational therapy, help for those experiencing problems with speech, and treatment for individuals suffering from a variety of disabilities.) Although all EHB must be covered without annual or lifetime caps on the dollar amount of the benefits, it’s very common to see plans with caps on the number of visits an enrollee can have for services like physical therapy or occupational therapy."
Obamacare’s essential health benefits