Frequently Asked Questions What is Affordable Care Act? What is the "Health Insurance Marketplace"? How do I enroll for marketplace coverage? I signed up for a DentaQuest Plan. What happens now? When does insurance coverage begin? Why can't I enroll through DentaQuest's website? What are "Essential Health Benefits"? What are my plan options? How I can find out if my dentist accepts DentaQuest insurance? Can I pay my bill online? I signed up for Marketplace coverage last year and I want to continue in the plan for another year. What do I have to do? Where can I learn more about the Affordable Care Act and the Health Insurance Marketplaces? What is Affordable Care Act? The Affordable Care Act is a comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name “Affordable Care Act” is used to refer to the final, amended version of the law. What is the "Health Insurance Marketplace"? The Health Insurance Marketplace (Marketplace for short), which officially opened October 1, 2013, is resource where individuals, families, and small businesses can: Learn about their health coverage options Compare health and dental insurance plans based on costs, benefits, and other important features Choose a plan Enroll in coverage The Marketplace also provides information on programs that help people with low to moderate income and resources pay for coverage. This includes ways to save on the monthly premiums and out-of-pocket costs of coverage available through the Marketplace, and information about other programs, including Medicaid and the Children’s Health Insurance Program. Consumers do not have to purchase insurance through the Marketplace. They can still get insurance through their employer or purchase insurance directly from insurance companies. The Marketplace encourages competition among private health and dental plans, and is accessible through websites, call centers, and in-person assistance. In some states, like Pennsylvania, the Exchange is run by the state government. In others, like Florida, Texas and Virginia, it is run by the federal government. How do I enroll for Marketplace coverage? If you live in Arizona, Florida, Georgia, Illinois, Indiana, Louisiana, Missouri, Ohio, Tennessee, Texas or Virginia, you can apply for individual, family or small group dental coverage, compare plan options, and enroll in one streamlined application by logging on to HealthCare.gov. If you live in Pennsylvania you can apply for individual and family coverage, compare plan options and enroll in one streamlined application by visiting Pennie.com. Open enrollment for families and individuals begins November 1, 2020, and closes on December 15, 2020. I signed up for a DentaQuest plan. What happens now? First, thanks for signing up with DentaQuest! You will receive an invoice in the mail around 10 days after you signed up. The invoice will give you a handy link to the DentaQuest Member Portal where you can sign up to view your account and pay your bill on line if you choose. Once you’ve paid your premium, you'll receive your Welcome letter and member ID card. In order for your coverage to be effective January 1, 2021 you will need to make your premium payment in December. If you haven't paid your premium, you will not receive your card and your coverage won't go into effect until you pay the premium. When does insurance coverage begin? Coverage begins January 1, 2021. If you purchase one of our plans, you’ll receive a welcome letter and member ID card before this date. You’ll need to bring your member ID card with you to the dentist. Why can't I enroll through DentaQuest's website? To make it easy for consumers, the government created a single standardized Marketplace application located on the HealthCare.gov website for consumers located in Arizona, Florida, Georgia, Illinois, Indiana, Louisiana, Missouri, Ohio, Tennessee, Texas and Virginia. During the application process you can learn if you can get lower costs based on your income and compare your coverage options side-by-side. In Pennsylvania the application is located at Pennie.com which is a State Based Exchange (SBE) for 2021. What are “Essential Health Benefits”? Essential health benefits are a set of health care service categories that must be covered by certain plans, starting in 2014. The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include items and services within at least the following 10 categories: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care The pediatric dental benefit is for children under age 19, has no annual or lifetime maximum, and has a limit on how much the consumer pays for pediatric services out of pocket each year. What are my plan options? Plan options vary by state. Simply select your state on the left side of this page. You’ll be redirected to page where you can review plan benefit summaries, which provide an overview of the types of services that are covered, if it offers in- and out-of-network benefits, and if the plan has co-pays, deductibles or maximums. How I can find out if my dentist accepts DentaQuest insurance? You can use our Find-A-Dentist tool to determine if your dentist accepts DentaQuest insurance. Simply select your state on the left side of this page. Can I pay my bill online? YES! Once you have you receive your ID cards you can use your ID number to log on to https://member.dentaquest.com/maintain. There you can choose online billing and payment. It is a convenient way to make sure that you are never forget your payment and it helps keep premiums affordable. I signed up for Marketplace coverage last year and I want to continue in the plan for another year. What do I have to do? Great News! Your coverage may automatically be renewed; even so, you may want to take steps to renew it yourself during Open Enrollment this fall. If you are receiving a premium tax credit, it is wise to go through the process so that you can update your income and family information and see how much tax credit you may be eligible for based on the new premiums for 2021. For Federally Facilitated Marketplace (FFM), Open Enrollment for 2021 plans begins on November 1, 2020 and continues through December 15, 2020. Pennsylvania has a state-based marketplace with the Open Enrollment period of November 1, 2020 to January 15, 2021. The process for renewing coverage may be a little different depending on where you live. In federal Marketplace states that use HealthCare.gov or Pennie.com if you are currently enrolled in a Marketplace policy and you don’t take any action before December 15, 2020, in most cases the Marketplace will automatically renew your coverage under that policy for 2021. We may not offer all of the same plans next year that they offered in 2020. If your dental plan is no longer being offered in 2021 and you do nothing, we will automatically enroll you in another policy that is most similar to one you have now. Where can I learn more about the Affordable Care Act and the Health Insurance Marketplaces? Visit HealthCare.gov or Pennie.com to learn more about the Affordable Care Act and the Health Insurance Marketplaces.