Alabama dental insurance guide

For adults who purchase their own stand-alone dental coverage through the exchange in Alabama, premiums in May 2024 ranged from about $7 to $41 per month.¹

If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the health plan has integrated pediatric dental benefits.

All stand-alone pediatric dental plans available through the Marketplace/exchange in Alabama will comply with the Affordable Care Act’s (ACA) pediatric dental coverage rules. This means out-of-pocket costs for pediatric dental care will not exceed $400 per child in 2024 (or $800 for all the children on a family’s plan), and there is no cap on medically-necessary pediatric dental benefits.

The specific coverage requirements for pediatric dental care must follow the state’s essential health benefit (EHB) benchmark plan.

Alabama’s benchmark plan includes coverage for both basic and major dental services for children.

In 2024, there are nine insurers that offer stand-alone individual/family dental coverage through the health insurance Marketplace, with coverage available for both adult and pediatric dental services. There are dental plans that are not included with a medical plan and must be purchased separately.

These plans can be purchased through HealthCare.gov during open enrollment (November 1 to January 15) or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA’s rules for pediatric dental coverage.

There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in Alabama. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Alabama Department of Insurance. If you would like to purchase a non-ACA qualified dental plan, talk to your agent or search online.

There are also various dental discount plans available in every state. Dental discount plans are not insurance, but can offer discounted rates at participating dentists. Here’s useful information about the differences between dental insurance and dental discount plans.

To find plans in your area, search online for dental discount plans and the state you are looking to buy a plan in.

For adults enrolled in Medicaid in Alabama, there is no dental coverage provided for any level of care. For fully eligible children (up to age 21), Medicaid in Alabama does provide routine preventive and restorative services.

ALL Kids (Alabama’s Children’s Health Insurance Program), a low-cost healthcare coverage program, provides dental coverage to eligible children and pregnant women, even if their income is above the eligibility limits for Medicaid. ALL Kids enrollees are able to receive up to $1,500 in covered dental benefits per year. (A dental provider can request approval from the plan for services in excess of that limit.)

• Alabama Dental Association
• Low-fee dental clinics in Alabama
• Alabama Medicaid
• HealthCare.gov