Under the ACA essential health benefits rules, adult dental and vision coverage is:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under the ACA's essential health benefits (EHB) rules, pediatric dental and vision coverage are mandatory components of qualified health plans. Adult dental and vision care, however, are not required: plans may offer them as optional, separately rated benefits. This asymmetry is a common exam trap because candidates remember that dental and vision are part of the EHB categories, but the mandatory EHB coverage applies to children, while adults may be offered such coverage only on an optional basis. Plans may also provide adult dental and vision as separately rated benefits, but nothing in the EHB rules compels them to do so.
Why the other options are wrong
- B) Adult dental and vision are not mandatory under the EHB rules; only limited pediatric dental and vision coverage must be included.
- C) Adult dental and vision are permitted, not prohibited; plans may offer them as optional riders or benefits.
- D) There is no age threshold such as 55 that makes adult dental or vision coverage required; it is simply optional.
Memory hook
Kids get dental and vision for free; adults pay extra if they want them. Kid-mandatory, adult-optional.