The Importance of Vision & Dental Plans

Did you know that individuals with dental and vision insurance are more likely to visit the dentist and ophthalmologist and have better overall health compared to those who don’t?

Those who need corrective lenses should consider going to the optometrist or ophthalmologist regularly to get their eyes checked for overall health. For overall oral health, visiting the dentist regularly should be the protocol for ALL, and dental insurance can defray the costs of regular exams as well as any additional dental work one may need.

There is an added benefit of regular dental and health exams: They can detect the early stages of other health issues that may be building up without your knowledge.?Most germs in our bodies are stored in our mouths!

Both vision and dental insurance are reasonably priced, and if you use these services regularly, you will benefit from lower out-of-pocket costs.

Vision coverage

Vision insurance can help you pay for yearly eye exams and corrective lenses.?Even if you don’t have vision problems, your healthcare provider might suggest you get a routine eye exam every two years.?If you have impaired vision or a family history of eye disease, your eyes checked annually.

Preventative coverage plans usually include one eye exam every 12 months with a set copay with one of the plan’s contracted providers. If corrective lenses are required, most plans will cover the cost of a set of single-vision, bifocal, or trifocal standard plastic eyeglass lenses, with a standard copayment.?Typically, the plan will pay up to a certain amount, $150 to $200 is the norm, towards contact lenses for a year.?Some plans may also include discounts on Lasik surgery.

How dental insurance works

Dental insurance provides benefits that help cover part of the costs of your dental services. They usually feature three categories of benefits:

• Preventative?— This covers routine exams, X-rays, and cleanings.
• Basic?— This will cover fillings, root canals, wisdom tooth extraction, and other simple extractions.
• Major?— This covers crowns, implants, bridges, and oral surgery.

Some plans will not cover basic or major care immediately and may have a waiting period for these procedures. They do so to keep people from buying insurance just because they need this work.?This is called “buying a claim,” meaning, taking out new insurance to submit a new claim the first month.?If you have pre-existing conditions, it is important to find a plan with no waiting periods for pre-existing conditions!

Dental plans have a benefit year or annual maximum meaning, a cap on how much your policy will pay for covered services. If you need additional care after you meet this maximum, you will be billed for 100% of the cost.?

Dental plans are like health insurance, and some are set up as preferred provider organizations (in and out of network), fee-for-service, or health maintenance organizations. Fee-for-service plans are the most liberal and will cover the costs of any dentist you visit, but premiums are higher.

For PPO and HMO (in-network only) plans, you will have to stick with going to dentists in their network or risk paying all or a significant portion of the costs if you go out of network.

The health benefits

The benefits of annual appointments with an ophthalmologist go well beyond keeping your eyes in working order. Exams can reveal a host of systemic disorders sometimes before other symptoms become evident:

• High blood pressure
• Heart disease
• Diabetes
• Rheumatoid arthritis
• Thyroid disorder
• Parkinson’s disease
• Cancer
• Multiple sclerosis

Regular dental exams can detect poor nutrition and hygiene, improper jaw alignment, and signs of developing oral and overall health problems, including:

• Diabetes
• Leukemia
• Oral cancer
• Pancreatic cancer
• Heart disease
• Kidney disease

Who needs these plans?

You will often get a preferred rate if your employer offers these plans, so that will usually be the best option. If you don’t have access to employer-sponsored dental and vision coverage, you should strongly consider it if:

• You are self-employed.
• You are in between jobs.
• Your child is in college but doesn’t have coverage through a parent or access to coverage with network providers where they attend school.

Prices for these policies will vary among insurers and the different plans they offer. Your premium may differ based on age, residence, or what type of coverage chosen. For business owners, we have access to discounted stand-alone plans whereby owners are not obligated to cover their employees.

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