Meeting the challenges of health care reform together

Our expertise and leadership in the health care reform process is helping to guide development of dentist-friendly policies and rules. Through work with key lawmakers and regulators, we’ve acquired the expertise needed to help supply a steady stream of new patients to Delta Dental dentists as the nation moves toward launching state/federal health care exchanges and beyond.

We’ll help you do your best by doing our best

When it comes to the Affordable Care Act’s (ACA) pediatric oral care requirement, our group of Delta Dental member companies (Delta Dental*) is your advocate and inside source for the latest information.

We’re prepared

We were at the forefront during development of ACA policies and subsequent rulemaking by the Department of Health and Human Services (HHS), successfully establishing our expertise and leadership with key lawmakers and regulators.

We continue to influence the health care reform process by serving as advisors to state officials working to establish their health exchanges. We’re also guiding development of dentist-friendly policies and rules within state and federally-facilitated exchanges.

We’re experts

We’ve acquired the expertise needed to help supply a steady stream of new patients to Delta Dental dentists as the nation moves toward launching state health care exchanges and beyond.

Our health care efforts will help boost dental practices

To prepare for the 2014 launch of state exchanges, we’ve developed dental plans that meet all ACA standards and HHS guidelines for pediatric oral care (as well as supplemental plans for adults), for purchase inside and outside of exchanges.

We’re offering our expertise to partner with medical plan carriers because we can administer the dental plans, relieving them of concern about these highly specialized benefits.

We’ll participate in the exchanges of all 15 states, plus the District of Columbia, where we are licensed, as a standalone dental carrier and where possible, in conjunction with medical plan partners.

We’re working closely with several state dental associations to push for policies and rules that will preserve dentist-patient relationships.

You can count on us

Our ACA-compliant plans and dental benefits expertise, both inside and outside of exchange markets, assures you of a continuing high level of service, rapid claims processing and payment, more efficient ways to verify patient eligibility and benefits and help with understanding new kinds of coverage.

We’re committed to shaping new dental plan products for millions of Americans and providing new patients for Delta Dental dentists.

The 10 essential health benefits

The Affordable Care Act ensures Americans access to reasonably priced, comprehensive health insurance. To meet this objective, individuals and small groups, both inside and outside of health care exchanges, must obtain these 10 essential health benefits:

1. Pediatric services, including oral and vision care
2. Ambulatory patient services
3. Emergency services
4. Hospitalization
5. Maternity and newborn care
6. Mental health and substance use disorder services, including behavioral health treatment
7. Prescription drugs
8. Rehabilitative and habilitative services and devices
9. Laboratory services
10. Preventive and wellness services and chronic disease management

Health care reform abbreviations

ACA: 

Affordable Care Act

ACO: 

Accountable Care Organization

Co-op: 

Health insurance cooperative

EHB: 

Essential health benefits

Exchange: 

Affordable Insurance Exchange

HCR: 

Health care reform

HHS: 

Department of Health and Human Services

* Delta Dental includes these companies in these states: Delta Dental of California — CA, Delta Dental of Pennsylvania — PA & MD, Delta Dental of West Virginia — WV, Delta Dental of Delaware, Inc. — DE, Delta Dental of the District of Columbia — DC, Delta Dental of New York, Inc. — NY, Delta Dental Insurance Company — AL, FL, GA, LA, MS, MT, NV, TX and UT.