Vision and dental coverage plans are not automatically included in marketplace health policies. Are you covered for vision and dental care? Check your health plan benefits – you may already be covered. If not, you can buy a stand-alone plan.
You can purchase a stand-alone vision plan from a network provider – in most cases, you can purchase your vision plan from the same provider that holds your health insurance policy. Some carriers may offer discounts if you purchase multiple plans from them. Like your health insurance, a vision plan will require a premium (usually paid monthly). As long as you stay within the parameters of your plan (don’t buy designer frames or extra contacts, no unnecessary appointments), you may only need to pay a small co-pay when you visit your eye doctor ($25-$30).
Vision plans usually cover routine check-ups with your optometrist and appointments for concerns. Glasses and contacts are usually covered as well, however, glasses are often the cheaper option because contact lens fittings are usually not included in vision plans. Also remember that glasses frames are only covered under a certain dollar value which you can find in your plan, so don’t automatically reach for the Gucci frames!
There are three types of vision plans: HMO, PPO, and indemnity. With an indemnity plan, you can choose any provider (doctor). With an HMO plan, your costs will be lower but you can only visit a doctor within your plan’s network. With a PPO plan, you have the freedom to choose any provider you like, but the providers in your network will be cheaper for you.
Unfortunately, you can only buy a dental plan if you’re buying a health plan at the same time. That’s why it’s important to know about all your options before you purchase health insurance. If the health plan you select does not include its own dental plan, you can purchase a standalone plan within the same purchase. Dental is considered an essential benefit for kids (18 and younger) but not adults, which means that your health plan doesn’t have to let you receive dental benefits, but it has to offer them for your kids. You don’t have to buy a dental plan for your kids, but your carrier has to have it as an option.
Like basic health plans, you can purchase a dental plan that has a high premium but a low deductible, or a plan with low premiums but a high deductible. If you expect to spend a lot of time at your dentist, you may be better off with a high premium so you don’t have to pay as much out-of-pocket. If you only expect to visit your dentist once a year, then you might pay less if you choose a lower premium option.
Typical dental plans cover 100% of preventative care costs like cleanings and 80% of basic procedures like fillings and root canals. Major procedures like crowns and bridges are usually about 50% covered. Cosmetic dental work is almost never covered, and it can get pricey.
For help sorting through your benefits or choosing a dental plan, call HealthTN at 615-541-4257.