ACA Dental for Self-Employed People

Traditional healthcare and dental insurance policies are often seemingly unattainable for people who are self-employed. Premium prices for an individual rise sharply every year, while deductibles and co-pays are also sky high. Unless you can access insurance through a trade organization or union, the costs were often prohibitive to those living on a feast-or-famine income.

One of the stated goals of the ACA was to provide affordable healthcare benefits to Americans who may not have had the ability to purchase them in the past. Unfortunately, we still haven’t quite achieved that goal when it comes to making dental care accessible to everyone.

ACA advantages and challenges

You can enroll for ACA healthcare insurance through the Marketplace if you’re a freelancer, consultant, independent contractor, or other worker who delivers services to customers but doesn’t have any employees. You can buy a healthcare policy, which may include dental coverage, on healthcare.gov or via your state’s own exchange (enter your zip code at Healthcare.gov to see if your state has its own exchange).

When you fill out a Marketplace application, you’ll find out if you qualify for premium tax credits and other savings on a health plan. This will be based on your income and household size. You can do a quick check to see if your expected income is in the range to save.

There is one challenge for self-employed folks hoping to reduce the cost of insurance via ACA subsidies: When you fill out a Health Insurance Marketplace^® application, you’ll have to estimate your net self-employment income. Marketplace savings are based on your estimated net income for the year you’re getting coverage, not last year’s income. Since income can be unpredictable when you are self-employed, you may find that you over or underestimate your income and will end up paying more (or less) than you anticipated for your insurance.

If you qualify for subsidies, the ACA can be a wonderful way to get affordable healthcare. And if you have kids, ACA dental insurance can do an excellent job at meeting your family’s dental care needs (ACA pediatric dental insurance options are often more attractive than adult-only plans). Find out more about dental care insurance via the ACA, including costs, limitations, and advantages for self-employed people and freelancers.

If you’re purchasing insurance for yourself or you and your spouse, you may want to review options for dental coverage outside of the marketplace. Dental savings plans are often an excellent choice for self-employed people as they are more flexible – and affordable – than traditional dental insurance. See the section below for more information on dental savings plans.

ACA insurance for small businesses

If your business has even one employee (other than yourself, a spouse, family member, or owner), you may be able to use the SHOP Marketplace for small businesses to offer coverage to yourself and your employees.

In the Marketplace you can choose from several categories of coverage, from plans with low premiums that protect you in worst-case scenarios to plans where you will pay more each month but less out-of-pocket when you get health care services.

Here’s where the savings come in: you may qualify for the Small Business Health Care Tax Credit that could be worth up to 50% of the costs you pay for your employees’ premiums (35% for non-profit employers). To qualify for the tax credit, all the following must apply:

• You have fewer than 25 full-time equivalent (FTE) employees
• Your average employee salary is about $56,000 per year or less
• You pay at least 50% of your full-time employees’ premium costs
• You offer SHOP coverage to all your full-time employees. (You do not have to offer it to dependents or employees working fewer than 30 hours per week to qualify for the tax credit.)

Find out more about the Small Business Health Care Tax Credit and get the details on SHOP dental coverage.

Reducing the cost of dental care – Know your options

Dental insurance is not the only (or always the best) choice for reducing the cost of dental care depending on your specific needs. Most dental insurance policies impose waiting periods – typically 12 months from the start of the policy – before they will cover major procedures. They often do not offer coverage for pre-existing conditions or pay to restore teeth that were missing before you purchased the policy. And the amount your policy will pay out after you meet the annual deductible is typically capped at around $1,000 – $1,500.

Dental savings plans (also known as discount dental plans) are an affordable alternative to insurance. Plan members report saving an average of 50%* on their dental care. And, unlike dental insurance, dental savings plans have no annual limits, no restrictions on existing health conditions, and your savings start right away, even on restorative care such as root canals, crowns, dentures, and dental implants. Many plans even include cosmetic dental procedures such as teeth whitening and overlays. And since there are no open or closed enrollment periods, you can purchase a dental savings plan whenever you want or need one.

It’s simple to choose a plan at DentalPlans.com, the largest marketplace for dental savings plans and dental insurance. You can compare more than 25 plans from the most trusted brands in healthcare, and easily join your selected plan. Want a personalized recommendation? Give us a call at 1-833-735-0399 or use our calculator below.

*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.