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- Kat Gardner, 22 Aug 2024
Choosing the Right Vision and Dental Insurance
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Taking care of vision and dental health promotes optimal whole-body wellness. From enjoying the immediate benefits of clean teeth and clearer vision to preventing larger health issues down the road, maintaining good vision and oral health can have lasting health benefits. In this article we are exploring some frequently asked questions about dental and vision insurance to help you better understand the important role that these types of insurance plans can play in your overall well-being.
Dental and vision insurance are designed specifically for oral and vision-related care, respectively. Both vision and dental insurance plans work by covering part of the cost for specific services, such as exams. Additionally, vision plans also often help cover corrective lenses and contacts to help with daily corrective needs.
There are two main types of insurance: traditional plans and alternative-coverage options.
1) Traditional dental and vision insurance
Traditional vision and dental insurance coverage works similarly to traditional health insurance. You’ll have either a monthly or annual premium (the fee you pay for continued coverage), a deductible (the amount you’ll have to pay out of pocket before your insurance starts kicking in) and copayments/coinsurance (the portion of the bills that you pay).
These types of insurance plans can operate as HMOs (typically more restrictive about networks), PPOs (offer a little more freedom with network requirements) or indemnity plans (operate as a reimbursement system where they’ll reimburse policyholders after claims are submitted).
2) Alternatives to dental and vision insurance
The most common alternative to traditional vision and dental insurance plans are discount programs. By joining one of these programs, your monthly fee makes it possible for you to access contracted discount options. With these programs, you are limited to only those contracted providers, which can impact your ability to find care near your location. If you go outside your membership’s provider list, you will have zero coverage for any services you receive.
According to the National Association of Dental Plans, nearly 27% of Americans do not have dental insurance. It is a serious issue because dental care includes more than just cleaning teeth; your oral health can affect your full body wellness. Maintaining good oral health practices can help detect and prevent more serious medical conditions and keep you healthy. One of the most important things you can do for your health is make sure you are getting regular dental checkups to find issues before they become serious.
Having impaired vision without using vision aids can severely impact your life and, if you are operating a vehicle, can even be dangerous to yourself and those around you. Vision insurance helps people get essential vision assistance to see more clearly and live a more functional life. And, just like dental insurance, the health of your eyes can also indicate other health issues, such as hypertension, which can cause serious issues if left untreated.
Essentially everyone can benefit from vision and dental insurance. The importance of taking care of oral and vision health isn’t limited by age, gender, or race. We all can benefit from maintaining our health, and dental and vision insurance can help make it more affordable and accessible to do so. With insurance plans available for every budget, it is easy to find a VSP® vision plan that works for you. You can use our VSP Individual Vision Plan Selector to find your plan and get a vision plan quote.
Vision insurance offers specialized coverage for vision and eye health. Most vision plans will cover an annual eye exam. At this eye appointment your eye doctor will run a series of routine tests to assess eye health and any vision concerns. If vision issues are discovered, or already exist, your eye doctor will prescribe corrective lenses to help you see more clearly. Your vision insurance will likely make it easier for you to afford glasses or contacts.
Without vision insurance, the national average cost for an eye exam can be as high as $200. With vision insurance, it can be as low as a $15 copay. Savings on glasses can also be significant, depending on your vision plan’s lens allowance. And with low monthly payments usually under $20, vision insurance is designed to protect your eye health and to help you save money on your eye care and eyewear.
Dental insurance can be generally divided into four different plan types, all of which have various advantages and disadvantages based on the specific needs of your family. Typically, the more money you pay in advance, usually through a monthly premium, the more coverage you will have and the less you will have to pay once services are provided. The four plan types include the following, and are in order (loosely) based on their level of coverage:
Dental Health Maintenance Organizations (DHMOs)—define a set network of dentists that you must choose between. In doing so, you receive pre-determined, heavily discounted dental services that are primarily covered by your provider. Should you go outside the provider dentist network though, most DHMO plans will not provide any coverage or further access to the plan’s benefits. This can be seen as a major disadvantage, but as long as you stay in-network, you’ll enjoy a reasonable monthly premium, no maximum benefit limit, and a significant decrease in your overall out-of-pocket costs.
Dental Preferred Provider Organizations (DPPOs)—also provide you with a network of dentists but offer additional flexibility where DHMOs do not. When you stay in network, you will receive the maximum amount of covered services and benefits detailed under your plan, but even if you go outside the network, you will receive coverage equivalent to that of your DPPO plan. Your in-network dentist will offer services at a lower rate than an out-of-network dentist, and you will have to pay any difference in price out of pocket.
Indemnity plans—most commonly do not have a defined network. That means, you have the freedom to go to any dentist you would like without any strings attached. However, in return, you are required to pay for all of the services you and your family receive out of your own pocket, only to be reimbursed by your provider afterward. Depending on the type of indemnity plan and the type of services provided, your reimbursements could vary anywhere between 50% and 100%. For example, most routine services, like X-rays and cleanings, will be covered entirely, but you’ll likely be reimbursed at a lower rate for things like bridges and root canals.
Dental Discount plans—probably the most “laissez faire” dental plan type, although it is not a dental insurance plan, these plans also give you the luxury to go to any dentist that you choose. Instead of having to pay copays, deductibles, or reimbursable service fees though, you pay a monthly or annual membership fee and receive discounts on the services that you and your family use. The flexibility is a major benefit, but you may experience more out-of-pocket costs, especially if you have a year where many dental trips are necessary or if you have a bigger family.
Many Americans receive their vision and dental benefits through their workplace. When you are interviewing for a job at a company, vision and dental options may be discussed as part of the full benefits package.
If your employment does not offer or qualify for insurance benefits, that does not mean you’re out of luck. Many companies, including VSP, offer voluntary insurance plans for those enrolling outside of a workplace or other group health setting. Where you work should not limit your access to finding great coverage.
Medicaid typically does not cover vision or dental services unless it’s for a minor. Even then the vision and dental coverage offered is typically limited. However, states have some flexibility when it comes to dental care specifically, which is offered most often on an emergency basis. Check with your state’s specific Medicaid rules to find out what vision and dental coverage options you have in your area.
Absolutely! There are vision and dental insurance options available for both individuals and families. You can get coverage for you, your partner, and your kids easily with VSP. VSP vision plans are flexible to fit your needs. And for seniors of Medicare age, you can add vision and dental coverage as well. Original Medicare does not typically cover either, much like Medicaid, but some Medicare Advantage plans, and Medicare-focused dental and vision plans cater specifically to those looking for additional coverage in these vital areas. Learn more about the benefits and savings of a VSP Vision Plan.
Ultimately, each dental insurance and vision insurance plan has different costs and conditions that vary significantly, depending on which benefits they offer in comparison to other insurance plans. The best advice is to read through the insurance plan details carefully before arriving at your final decision. Naturally, if you elect a coverage plan with lower monthly or yearly costs, then the coverage in some plan benefit areas might be limited or not apply at all. You know the ultimate needs of your family better than anyone else. Nobody is in a better position to decide which type of dental and vision insurance plans best meet those needs based on your monthly budget.
The cost of dental insurance for your family may vary widely. Doing a little research to find the right dental insurance plan can help you save money, while keeping you and your family’s teeth healthy. While researching the details of different insurance plans and considering their costs, you’ll notice a typical plan’s 100-80-50 coverage structure. With the exception of discount plans, this means that 100% of the costs for preventative procedures, like bi-annual check-ups, cleanings, and X-rays, are covered; 80% of the costs of basic procedures, like fillings and root canals, are covered; and 50% of more intensive procedures, to include crowns and bridges, are covered.
Good news! VSP offers a variety of vision plans to fit your needs and your budget, and our partnership with Guardian Direct Dental allows you to explore all your vision and dental coverage options. We make sure our vision and dental plans help you stay healthy without breaking the bank.
With a VSP Individual Vision Plan you purchase on your own you can save each year on vision costs, from eye exams to eyeglasses and contact lenses. Learn more about your vision and dental insurance plan options today. Once you’ve completed your vision plan enrollment, keep your eyes open for dental insurance plan options from Guardian Direct®. Get the care your eyes and smile both need!
Information received through VSP Individual Vision Plans’ social media channels is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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Healthy vision association discounts
Some plans can only be accessed through membership in the Healthy Vision Association (HVA), which helps its members see well and stay healthy.
For $1.50/mo, your membership will give you access to exclusive discount programs* on everyday goods and services including:
Plus, your membership supports vision-related charities too.
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*All rebates and special offers are subject to change