When the pediatric dental benefit is part of a medical plan, a member may end up paying more out-of-pocket costs for dental services than with a stand-alone dental plan, due to having to meet their medical deductible or medical out-of-pocket maximum before being able to access their full dental benefits.

Medical carriers are not experts in dental care, and are unlikely to provide the size of network, level of coverage and streamlined processes for handling claims that dental carriers do.   

Keeping dental separate lessens the impact of the Cadillac Tax, which will be imposed on medical plans beginning in 2018 — stand-alone dental carriers are exempt from the tax.

According to the American Hygienist Association, dental care is critical to the overall health of the individual and the country, as 50 percent of Americans don't receive regular oral health care. With PPACA not including adult dental care as one of the essential health benefits, no wonder there's a huge gap in coverage that has the potential to grow even greater in the years ahead. Here is a recent infographic with some amazing dental health stats:

There's no doubt that dental care is important to maintain good physical health. Improving the oral health of people with chronic medical conditions such as diabetes, asthma, and cardiovascular disease can reduce healthcare costs, according to a study completed by United HealthCare this year.

As reported by Dr.BiCuspid.com, the UHC study compared the medical and pharmacy costs of individuals with six chronic medical conditions with the dental treatment they received to determine if there is a difference in total health care costs associated with varying dental treatments.

The dental treatments included in the study were periodontal treatment, cleanings, and other or no dental treatment, according to UHC's report. Chronic medical conditions included diabetes, asthma, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, and chronic kidney/renal failure. Here are some of the study's other findings:

• Total average medical costs were lower across all chronic conditions for people who received periodontal treatment or cleanings compared with those who did not receive such services, even after accounting for the costs of additional dental treatments.
• People with chronic conditions who received regular cleanings (at least three times during the three years) had the lowest healthcare costs of any other dental treatment group (i.e., infrequent cleanings, no cleanings).
• The savings were also significant for people who received regular dental care but were not compliant with the recommended care for their chronic medical condition. Among the group receiving dental care, annual average medical costs were lower than those not receiving dental care.

Many health care providers acknowledge that oral health is a vital component of overall health. Even the Surgeon General and the Institute of Health have touted publicly that oral health is critical to good physical health.

But according to Health Affairs online, when it comes to a major determinant of oral health — access to routine dental care — PPACA falls well short in all three of the 'triple aims': lowering costs, increasing access, and improving health outcomes, mainly when it comes to adults.

According to DrBicuspid.com, many Americans delay treatment for oral health issues due to financial concerns or a lack of access to care. Consequently, preventable issues often become complicated ones before treatment takes place.

A study published by the Journal of Endodontics stated inadequate insurance is likely a factor, since access to care hinges on having dental insurance in the United States, and as many as 25 percent of adults 65 and younger lack it, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. Meanwhile, the burden on Medicaid to pay for discharges related to dental emergencies has jumped 74 percent. Medicaid, in its current form, doesn't cover dental care for individuals older than age 21. A few states have increased Medicaid dental coverage, but many have decreased or eliminated it altogether.

So, the big questions are, who gets dental coverage, and how much is it going to cost? At present, there are a lot of players in the mix — the ADA and state dental associations, exchanges both public and private, politicians and lobbyists, the healthcare companies and insurance carriers, state governments and the HHS, agents and brokers, employers and employees, HR managers, individuals and families, dentists and large dental practice management groups, and the list goes on.

At the end of the day, sticker shock for the ones who must choose what to do and where to go is going to happen soon. Amid all the confusion, the light at the end of the tunnel hopefully is a way out instead of an oncoming train. There are choices, but which one is the right one for you? Whether you go with dental insurance or a dental savings plan, the writing is on the wall — dental is going to be completely voluntary for anyone who wants it. Gone are the days of employer-paid dental benefits.

There are some good dental insurance plans in the market, including Assurant and Morgan White. And, there are dental savings plans are an acceptable industry option for quality dental care, including Aetna Dental Access and Careington. According to the National Association of Dental Plans, "the growth and popularity of discount dental plans is related to the scarcity of individual products offered by insurance plans and growing consumer demand to control dental health care costs. By creating an inexpensive vehicle to enable access to dental care, discount dental plans have successfully met the demand from uninsured, underinsured, self-employed, retired, temporary or part-time workers.

With an estimated 50-plus percent of Americans not having any type of dental coverage, and the dental insurance marketplace offering few, affordable dental products for individuals, discount dental plans are an attractive answer to the need to reduce consumer out-of-pocket costs and increase access to care."

But does affordable dental care exist? Yes, it does, if you know where to look. Don't wait until the last minute to find the best plan for you, or your company. Those who go to market with the best product have the best opportunity to win the day in the dental care world. Those who do their shopping homework are going to end up with the best coverage.

Also read:

• Dental enrollments jump to record high
• Dental-related ER visits straining health care system
• Will Dental and Vision Coverage Change Under the Affordable Care Act?