Through Get Covered Illinois, you can get dental coverage two ways: as part of the health plan you buy, or by itself through a separate, stand-alone dental plan. If a health plan includes dental benefits, the premium covers both health and dental coverage.
Pediatric dental care is considered an essential health benefit. This means if you're getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan.
NOTE: While dental coverage for children must be available to you, you don’t have to buy it.
However, dental coverage isn't an essential health benefit for adults. Insurers don't have to offer adult dental coverage as part of their qualified health plan (QHP); however, stand-alone dental plans (SADP) are available through Get Covered Illinois. To be eligible to shop for and enroll in a SADP on Get Covered Illinois, you must meet QHP eligibility criteria. If you choose a separate dental plan, you’ll pay a separate, additional premium.
There are two categories of Get Covered Illinois dental plans: High and low.
- The high coverage level has higher premiums but lower co-payments and deductibles. So, you'll pay more every month, but less when you use dental services.
- The low coverage level has lower premiums but higher co-payments and deductibles. So, you'll pay less every month, but more when you use dental services.