What Are Dental and Vision Plans
Oral and eye health are often overlooked by consumers who are thinking about health insurance. Still, a dental or vision plan can offer extremely helpful coverage that helps you maintain your overall health. Here’s what you need to know about dental and vision insurance.
Why Do You Need Dental And Vision Insurance
Dental and vision insurance is often essential, especially as you grow older. Vision insurance is important because it allows you to receive eye care affordably. With routine eye exams, you may be able to detect a number of different serious medical conditions, including diabetes and hypertension. Likewise, oral exams and routine care can help you manage a wide range of different health conditions. For example, the inflammation caused by periodontal disease can contribute to cardiovascular disease down the road. By getting routine dental treatments, you can prevent periodontal disease and limit the strain on your body.
How Does Dental Insurance Work
In exchange for monthly premiums, dental insurance will provide you with coverage that helps you pay for dental services. There are two major categories of dental insurance; basic coverage and full coverage. Basic plans cover preventive care services, like cleanings, x-rays, and a few other basic procedures, like cavity fillings.
Full coverage, on the other hand, covers far more services and can significantly decrease your out-of-pocket costs for dental care. Though, full coverage typically has much higher premium costs than basic coverage. But the cost is usually worth it, because full coverage plans often cover a wider range of preventive dental treatments, including fluoride treatments and sealants.
With full dental coverage, you may have access to the following major benefits:
- Basic restorative care – Coverage will help pay for fillings, extractions, and non-routine X-rays.
- Major restorative care – Coverage will help pay for bridges, crowns, dentures, and other major procedures.
- Orthodontic treatment – If you need teeth alignment procedures, these benefits will help pay for braces and other types of teeth aligners.
Provider Networks
When it comes to dental insurance, there are typically only two basic varieties being offered by insurance coverage. They are Dental HMOs and Dental PPOs. There is a third option, called Indemnity plans, but they are uncommon.
Dental HMOs are dental insurance plans that restrict policyholders to only seeing providers that are within their plan’s network. Most HMO networks are quite limited, so it is difficult to see the same dentist regularly, but in exchange, you typically face lower costs and the plans have simpler fee structures.
Dental PPOs also have a network of dentists, but they are far less restrictive than HMO plans. Your PPO plan will typically let you seek care outside of the network, but doing so may come at a higher cost. If you choose a larger insurer, you may be able to find a plan that includes your current dentist within their network as well.
If you have an HMO, you don’t really have the option to see out-of-network dentists, but if you have a PPO, the choice is yours. Though, we suggest you always try to see in-networks providers, because your insurer negotiates discounted fees on your behalf.
Cost of Dental Insurance
Dental insurance requires plan participants to pay a range of out-of-pocket costs, like coinsurance, deductibles, and premiums. Premium costs vary from plan to plan, but the average American pays approximately $360 a year for dental insurance. Averages may be different in different states. Most plans also have a maximum annual benefit, that marks the maximum amount you are allowed to receive per year. In most cases, this limit will range from $1,000 to $2,000. This limit can be met quite quickly, so be sure to prepare for additional out-of-pocket costs if you need a serious dental procedure.