Another very strange Affordable Care Act rule

[catherine]

I have to get new health insurance this month because my old plan isn't being carried forward under the ACA. So I'm online filling out an application (after doing two hours' worth of modeling in Excel to get through the quagmire of what I'll be paying with a number of different scenarios.

So I get to a screen where it says the ACA requires getting pediatric dental insurance ($26 a month). So I checked "no" because that doesn't apply to me, and it kept coming back with an error message, so I went on live chat, and sure enough, even if I have no kids who are pediatric, I still have to purchase pediatric dental insurance. Is that crazy or what?? I'm not even buying myself dental insurance.

[Alan]

I don't think that's just another strange rule within the Affordable Care Act, the entire Act is strange. When we allow bureaucracy to rule our lives, the bureaucracy takes it seriously.

[catherine]

I am just flummoxed.. how stupid is that?

It's like walking up to McDonald's and ordering a Big Mac and then at the check-out they say, oh, and here's your happy meal, and you say, I don't have any kids. I don't want a happy meal. And they say, "Sorry, you have to buy it anyway."

If they needed to cover the price of children's dental universal coverage, why can't they just call it a tax surcharge or something. Why tell people they HAVE to buy something they have absolutely no need for? It's so crazy. Come on, Obama, a little Marketing 101 would do you good here!

[peggy]

Catherine, I don't know which insurance company you are going with, but they are pulling a fast one on you. Under the ACA, if you are getting a plan that covers a young person(kid) then child dental must be AVAILABLE to this policy, but you still DON'T HAVE TO BUY IT!

Here is the link and a excerpt from it:

https://www.healthcare.gov/can-i-get...e-marketplace/

"Adult and child dental insurance in the Marketplace

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 if you’re getting coverage for someone 18 or younger, dental coverage must be available as part of a health plan or as a stand-alone plan. While it must be available to you, you do not have to buy it.

This is not the case for adults. Insurers don’t have to offer adult dental coverage.

Under the health care law, most people must have health coverage or pay a penalty. But this isn’t true for dental coverage. You don’t need to have dental coverage, even for children, to avoid the penalty."

Never never never take an insurance companies word for anything. Never! This also goes for clinics/hospitals who send you bills after usage. First go to your insurance webpage and check dates and claims. Chances are your insurance company has paid already and the clinic/hospital "accidentally" sent the bill before they realized it.
Revisit that insurance company, read them the quote from the healthcard.gov site, then change companies! And tell them why. Don't do business with a company who is trying to fool you into buying something you don't need.

Oh, and no, the ACA isn't confusing or bad or communist-come-knocking at the door! (sorry Alan, foiled again!) Bookmark the site and use it. It really isn't complicated.

[catherine]

It's not that easy, peggy. This is a Kaiser response to a similar situation (I'm not Kaiser, but my complaint is the same.)

http://www.kaiserhealthnews.org/feat...-benefits.aspx

...even though the health law requires that children in individual and small group plans have access to dental coverage, people are not required to buy separate pediatric dental coverage if they buy a plan on the state health insurance marketplaces, or exchanges, unless their state specifically requires it.

But people who buy plans outside the state marketplace may not have the same flexibility, says Colin Reusch, a senior policy analyst at the Children’s Dental Health Project.

Outside the exchange, “There’s no exemption for that requirement to have pediatric dental coverage,” he says. “So if you’re buying insurance outside the exchange you may have to meet it.”

[ApatheticNoMore]

It would annoy me. Mostly because I've never even bought dental insurance for myself, considering the whole dental insurance concept a giant collasal waste of money. Cheaper to just pay the dentist for dental care. Something I can't exactly say for medical insurance even if I'd like to, as it is really is necessary to have medical insurance in this country. Though I suppose having kids might change that calculation on dental insurance (braces and all that).

If they needed to cover the price of children's dental universal coverage, why can't they just call it a tax surcharge or something. Why tell people they HAVE to buy something they have absolutely no need for? It's so crazy. Come on, Obama, a little Marketing 101 would do you good here!

and why even an option to check "no"? a little user interface design 101

[Alan]

(sorry Alan, foiled again!)

Not by a long shot Peg. I wonder why my wife and I are required to maintain maternity coverage, even though I had a vasectomy 25+ years ago and she's post menopause? It's not because we need maternity coverage, it's because the bureaucracy has determined that we can't have a "sub-standard" plan.

[peggy]

Well Alan, it's the same reason my plan covers prostate exams. Or people who dent their heads riding motorcycles even though I don't own or ride them. Or viagra! See, it isn't really easy to piecemeal plans for the general most-need- it items. I'm guessing you at one time needed maternity coverage and even though you're a guy, it was for you too, unless you are of the school who thinks women make way to much fuss about childbirth and should just suck it up. Considering we procreate as a species, most everyone needs this at one time or another.

Maternity coverage is a no brainer, unlike appendix or car crash or heart attack. We can anticipate this need. If only we could read a crystal ball and say, ok, i"m going to break my arm but I'm not going to have a heart attack so no heart attack coverage needed!

The real question is, why do you think this one very natural and totally expected health care need for the majority of citizens should be 'separated' from all other health care needs? Is it because it's 'the womenz' who need it therefore less important than some mans tonsils (which I don't have and by your reckoning shouldn't have to pay for)
Why separate it? It's a health care need. Just because it's women doesn't make it less of a health care need, or a lesser need. Despite what some may wish, even tea baggers don't simply squat in a field to give birth then go right back to digging potatoes. I'm guessing you don't need a mammogram either, but that's covered in health care policies. Even the polices of single men.

I am so tired of this...there's health care, then there's 'women's' health care, which is somehow lesser, or suspect. Maybe you want every policy to be gender specific. Then you could buy one for you and one for your wife. Think how you could complain about that!

[Alan]

Well Alan, it's the same reason my plan covers prostate exams. Or people who dent their heads riding motorcycles even though I don't own or ride them. Or viagra! See, it isn't really easy to piecemeal plans for the general most-need- it items. I'm guessing you at one time needed maternity coverage and even though you're a guy, it was for you too, unless you are of the school who thinks women make way to much fuss about childbirth and should just suck it up. Considering we procreate as a species, most everyone needs this at one time or another.

Maternity coverage is a no brainer, unlike appendix or car crash or heart attack. We can anticipate this need. If only we could read a crystal ball and say, ok, i"m going to break my arm but I'm not going to have a heart attack so no heart attack coverage needed!

The real question is, why do you think this one very natural and totally expected health care need for the majority of citizens should be 'separated' from all other health care needs? Is it because it's 'the womenz' who need it therefore less important than some mans tonsils (which I don't have and by your reckoning shouldn't have to pay for)
Why separate it? It's a health care need. Just because it's women doesn't make it less of a health care need, or a lesser need. Despite what some may wish, even tea baggers don't simply squat in a field to give birth then go right back to digging potatoes. I'm guessing you don't need a mammogram either, but that's covered in health care policies. Even the polices of single men.

I am so tired of this...there's health care, then there's 'women's' health care, which is somehow lesser, or suspect. Maybe you want every policy to be gender specific. Then you could buy one for you and one for your wife. Think how you could complain about that!

LOL Peggy, I always love your responses. They're always so.....?

No, I don't have anything against women, my wife & daughter and mother are all women and they're all very important to me. The maternity coverage was simply an easy example of things we (including my wife) don't need but are still forced to buy. We used to be able to tailor our choices to meet our needs but are no longer able to. Thanks Obamacare!

[peggy]

Sheesh! You aren't being 'forced' to get maternity coverage! If you don't have a baby, then you won't need this one thing that is covered in policies. I probably won't ever crash on a motorcycle, yet I'll just bet I'm being 'forced' to buy coverage for that particular need in my policy. All Obamacare did was say this is something that needs to be included in the long list of things-to-be-covered.

Again, you just don't get it. This isn't a special need thing like sky diving coverage, or explosive expert coverage (although I'll just bet those things are covered in my policy) This is a health care need that most of us benefit from. A HEALTH CARE NEED as in, you're in a hospital with doctors and everything and it costs. Why do you think we should go through the list of health care needs and select this one need instead of tonsillectomy to be excluded from coverage? And birth control pills..again, this is medicine that many women need. (yes, need, and no it isn't anyone's damn business why I need it) yet so many (you included I'm guessing) want to 'separate' this drug from all the other drugs and not cover it.
Gee, can we think of ANYTHING, any kind of male health care need that we will exclude simply because....half of us aren't men?

It's a pretty weak argument, and pretty clear where it comes from. It never even occurs to us to question health care coverage for anything male simply because it's men, so why do we question everything related to women's health care?