Colorado dental insurance guide

Premiums range from $0 to $232 per month for adults who purchase their own stand-alone or family dental coverage through the exchange.¹

IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Colorado in 2023 was $59.01.

If a family is purchasing coverage through Connect for Health Colorado, 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.

The stand-alone pediatric dental plans available through the Marketplace in Colorado (Connect for Health Colorado) will comply with the ACA’s 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),² and there is no cap on medically necessary pediatric dental benefits. (For 2025, the out-of-pocket maximums will increase to $425 and $850, respectively.³)

If a medical plan has embedded pediatric dental benefits, the maximum out-of-pocket limits described above are not applicable. However, there will be no limit on how much the plan will pay for pediatric dental care, since it’s an essential health benefit.

As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care are guided by the state’s essential health benefits benchmark plan.

You can see details here for Colorado’s benchmark plan, which does include coverage for both basic and major dental services for children.

In 2024, four insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Colorado. These are dental plans that are not included with a medical plan and must be purchased separately.

These plans can be purchased through Connect for Health Colorado 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 the Rocky Mountain State. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Colorado Division of Insurance. If you would like to purchase a non-ACA qualified dental plan, ask a dentist for recommendations 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 what you need to know 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.

Adults enrolled in Medicaid in Colorado (Health First Colorado), are eligible to receive comprehensive dental services up to $1,500 per year. Children are also eligible for comprehensive dental benefits.

Child Health Plan Plus (CHP+) is Colorado’s CHIP program, and it provides dental coverage of up to $1,000 a benefit year to children and pregnant women with income above the eligibility limits for Medicaid.

• Colorado Dental Association
• Colorado Mission of Mercy
• Colorado Dental Health Care Program for Low-Income Seniors
• Colorado free dental clinics
• Connect for Health Colorado
• Health First (Medicaid)