A Simple Guide to Vision and Dental Insurance

Vision and dental insurance are an important part of keeping you—and your budget—healthy.

The health of our eyes and mouths is no less important than that of the rest of our bodies. But vision and dental insurance are often excluded from traditional health insurance. While a health insurance plan can aid in the cost of a broken arm or a skin infection, a chipped tooth or fading eyesight is left up to dental and vision insurance.

Vision and dental insurance can come from different sources:

  1. There are health insurance plans that include vision and/or dental benefits. These can be offered by an employer or purchased on your own.
  2. There are separate, standalone plans for vision or dental benefits that can be used on top of a health insurance plan as a form of supplemental insurance. There are even dental and vision insurance “packages” that offer benefits for both.
  3. Medicaid provides vision and dental benefits for children in all states. In some states, Medicaid also provides coverage for adults.
  4. Many Medicare Advantage plans include vision and dental benefits for seniors.

No matter how it’s acquired, vision and dental insurance can be instrumental in helping to keep your health up and your medical costs down. But before you go shopping for plans, there’s plenty you should know about them.

Vision and Dental Insurance in the Workplace

Under the Affordable Care Act, companies with at least 50 employees are required to provide group health insurance for their employees or face a penalty. However, vision and dental insurance are not required as part of this mandate. 

As a result, vision and dental insurance benefits granted by an employer-sponsored plan are the exception, not the rule. In fact, only 53 percent of companies that offered health insurance in 2014 provided any sort of dental benefits, and only 35 percent of such companies offered vision insurance.

Meanwhile, according to a benefits trend study conducted by MetLife, the two most popular voluntary benefit programs for employees are vision and dental insurance.

Vision and Dental Insurance for Children 

While vision and dental insurance for adults is not a requirement of the Affordable Care Act, vision and dental benefits for children is a required benefit offer under all plans that qualify as “minimum essential coverage.”

This means that all children under the age of 19 enrolled in individual, family, and small group health insurance plans must be offered basic and preventive care for vision and dental.

Vision and Dental Insurance Through Medicaid

Dental insurance. Just like the Affordable Care Act, federal Medicaid guidelines only require dental benefits be made available to children. Some states have their own dental requirements for adults under Medicaid, while others do not offer dental insurance to adults at all.

Vision insurance. Medicaid offers coverage of eye exams, frames, and lenses to children under 21, but it’s up to each individual state to determine how much—and how often—the coverage is offered. 

Many state Medicaid programs offer similar coverage for adults and some states even provide coverage of glaucoma testing and treatment and even cataract surgery.

Original Medicare (Part A and Part B) typically does not provide vision or dental benefits but many Medicare Advantage plans do. 

If this all seems complicated, a licensed insurance agent can help you understand the options that are best for you and your family.

This article was written by Phoenix Captive Solutions C.F.O. Blake Coats, any views or opinions do not necessarily reflect the opinions of either Phoenix Captive Solutions LLC, or any associated entities.  

Feel free to write to Blake at blake.coats@phoenixcaptive.com  

Leave a Reply