Every health plan that we represent has embedded pediatric benefits. This means that pediatric services, including dental and vision care for children, are generally covered as part of the essential health benefits in most ACA-compliant health insurance plans.

For children under the age of 19, these services are required to be included, even in marketplace plans and employer-sponsored plans. This includes:

• Pediatric services such as routine check-ups, vaccinations, emergency care, and surgeries.
• Pediatric dental and vision care may also be included or offered as a separate standalone benefit (depending on the plan).

Here is an example of what you might see in your Summary of Benefits:

However, adult dental and vision care are usually not required to be covered under ACA plans. If an adult requires dental or vision coverage, it may need to be purchased separately. You can call one of our health agents to get a quote!