HHS releases final rules on essential health benefits

02/21/2013 | Health Affairs Blog

HHS will not require insurance plans to cover routine nonpediatric dental services or orthodontia deemed not medically necessary. Stand-alone dental plans must cover pediatric oral care, must be certified as either "high" or "low," and may have "reasonable" out-of-pocket limits separate from medical out-of-pocket limits. Medical insurance plans sold outside exchanges may exclude pediatric dental coverage if enrollees have obtained pediatric dental coverage by purchasing a stand-alone policy.

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