Under the ACA, which statement about dental and vision coverage is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under the Affordable Care Act, the essential health benefits (EHB) package includes pediatric services, and limited pediatric dental and vision benefits are included within that pediatric category, so they must be offered by non-grandfathered individual and small group plans. By contrast, adult dental and vision coverage is not part of the EHB package. Insurers may offer adult dental and vision as optional riders or separate policies, and individuals can also buy standalone pediatric dental plans through the marketplace. The distinction between mandatory limited pediatric coverage and optional adult coverage is a frequently tested ACA point.
Why the other options are wrong
- B) Adult dental and vision are not required; only limited pediatric dental and vision are mandated as part of the pediatric EHB category.
- C) Dental and vision benefits are permitted and widely sold; the ACA simply does not require adult versions, and pediatric versions are required.
- D) Vision is not a standalone EHB; it is part of the pediatric services category, and pediatric dental is equally required.
Memory hook
Kids' teeth and eyes are essential; adults' dental and vision are optional extras.