Dental & Vison

Basics of dental insurance

Dental insurance is designed to help with the costs of oral health care. How much is covered depends on the type of plan and the procedure, often categorized into three levels of care: 

• Preventive care: Covers 100% of services like routine exams, teeth cleanings, and X-rays. Many plans do not have a waiting period for preventive services.

• Basic care: Covers a percentage (e.g., 80%) of services such as fillings, non-impacted extractions, and root canals.

• Major care: Covers a lower percentage (e.g., 50%) of more extensive procedures like crowns, bridges, dentures, and dental implants. 

Common types of dental plans

• Dental Preferred Provider Organization (DPPO): Offers a network of dentists but allows you to see out-of-network providers for a higher cost. DPPO plans may have higher premiums, deductibles, and an annual maximum benefit.

• Dental Health Maintenance Organization (DHMO): Requires you to choose a dentist within a specific network. DHMO plans typically have lower or no deductibles and may charge a fixed copayment for services.

• Indemnity plans: Also known as traditional insurance, these plans give you a specific, limited benefit amount for covered services. 

Basics of vision insurance

Vision insurance helps cover the costs of routine eye care and vision correction. 

• Exams: Most plans cover a routine, preventive eye exam after a copay.

• Corrective lenses: Plans help pay for the cost of prescription eyewear, such as lenses for glasses or contact lenses.

• Frames and discounts: Coverage often includes an allowance for eyeglass frames and may offer discounts on corrective surgery like LASIK. 

Vision plan vs. vision discount plan

• Vision benefit plan: Covers a set amount for preventative care and includes discounts on contacts and glasses.

• Vision discount plan: Offers discounts on vision care, but the number of covered visits or the amount of coverage may be limited. 

What dental and vision insurance typically doesn't cover

It is important to note that dental and vision insurance do not cover everything. For instance, most dental plans do not cover purely cosmetic procedures, such as teeth whitening or veneers. In cases of injury or eye disease, your major medical insurance plan would likely provide coverage instead of your vision plan. 

Where to get coverage

You can get dental and vision insurance in several ways: 

• Employer-sponsored plans: Many employers offer dental and vision coverage as optional benefits.

• The Health Insurance Marketplace: Offers dental and vision plans that can be purchased in conjunction with a health plan.

• Private insurance companies: You can purchase stand-alone dental and vision policies directly from an insurance provider.