In an individual medical expense policy, coverage for adult dental care and adult vision care is generally treated as:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The PPACA essential health benefit package mandates only limited pediatric dental and vision coverage as part of the ten EHB categories. Adult dental and adult vision care, by contrast, remain optional in the individual market — insurers may offer them by rider, by separate policy, or as part of a broader plan design, but the law does not require them. This adult-versus-pediatric contrast is the exam point: children's basic dental and vision ride inside the mandatory EHB package, while adults' dental and vision are elective add-ons that vary by product and price. Recognizing which side of that line a benefit falls on is central to EHB questions.
Why the other options are wrong
- B) Only limited pediatric dental and vision are mandatory EHBs; adult dental and vision are not part of the mandated benefit package, so this answer attaches the pediatric rule to the wrong population.
- C) States do not prohibit adult dental and vision coverage; the products are lawful and widely sold but simply optional, so this answer invents a ban that does not exist.
- D) Adult dental and vision are also offered in the individual market, so restricting them to employer-sponsored group plans is incorrect and ignores the individual market's optional-rider availability.
Memory hook
Adult teeth and eyes are optional riders; kids' teeth and eyes ride in the mandatory EHB car.