Is Supplemental Dental and Vision Insurance Worth Buying?

Deciding if supplemental dental and vision insurance is worth your money can feel confusing, but it is a crucial question that you need to answer. Your teeth and eyes, these are completely fine, until one day, they are not.

That’s when the shock hits. A single root canal can cost more than 2000 dollars. A new pair of prescription glasses easily exceeds $500.

You may think that your typical health care policy has got you covered. Unfortunately, that rarely happens.

This is the gap dangerous zone on which millions of people live. They are one toothache or one blurry sign away for a huge, unexpected bill. This article will help you in winning this gap.

And we will break down the costs, weigh the benefits and expose the hidden “gotchas.” By the time you are done, you will know for sure whether this type of insurance is a smart investment or a waste of your hard-earned cash.

Let’s get started.

What Exactly is Supplemental Dental and Vision Insurance?

First let’s get clear what it is that we’re talking about. Supplemental dental and vision insurance is a policy that you need to purchase separately in order to cover services that your primary health insurance plan probably doesn’t cover.

Think of it as an add-on. Your primary health policy is responsible for doctor visits, hospital stays and major medical emergencies.

This supplemental plan on the other hand specifically addresses your oral and visual health requirements. These are often bought as individual dental insurance or a combination of vision plan.

Many people receive these benefits through an employer’s Group Health Insurance, but freelancers, retirees and people whose jobs don’t offer it must find coverage on their own.

Understanding the Insurance Gap

It’s a misconception that is common and costly that health insurance covers everything from head to toe. For historical and actuarial reasons, dentalcare and visioncare will often fall under categories.

As a result, they get excluded from most standard Health Insurance Plans. This brings a major financial risk for many families.

The Glaring Gap in Standard Health Insurance and Medicare

The truth is, your regular health insurance policy was not meant to cover regular dental cleanings or new eyeglasses. It’s designed for critical, unpredictable and frequently catastrophic medical events.

Insurers think of dental and vision needs as being more predictable and, thus, that need to be taken care of separately.

This is particularly true in seniors. Basic Medicare (Part A and Part B), is notorious for not covering dental and vision coverage.

It will cover a dental procedure if it’s medically-necessary to a larger, covered hospital procedure. For example, a jaw examination following an accident. However, it will not pay for cleanings, fillings or dentures.

This leaves millions of retirees scrambling to find medicare supplement dental options to prevent the occurrence of devastating out-of-pocket dental costs. Organizations such as AARP are accessible sources offering a great deal of resources to seniors navigating through such complex insurance choices.

Why Aren’t Dental and Vision Included?

This separation goes back decades. Actuaries, the statistician of the insurance industry, concluded that if a heart attack is an insurable risk, requiring a dental filling is almost a certain eventuality for most people over their life.

Because the need for the care is predictable, however, it’s more difficult to distribute the risk among a large pool of people in the same manner as medical insurance.

Therefore, dental plans and vision plans were created with their own distinct structures, which included different premium calculations, networks, and benefits limits.

Let’s Do the Math: Premiums vs. Out-of-Pocket Dental Costs

Here is the truth: it has all to do with simple math, the value of supplemental dental and vision insurance. Will you spend less on services than you pay for each month in premiums?

Let’s break it down. An average dental plan could cost you anywhere between $25 to $60 a month. That’s $300 to $720 per year.

Now compare this to having to pay it all by yourself. A single dental crown may easily cost $1,500. One major procedure can require more than two years of premiums.

The key is to be honest when determining your possible needs. Your budget for Health Insurance Premiums needs to factor in these additional necessary coverages too.

The Cost-Benefit Analysis Table

In order to make this crystal clear let’s compare the numbers side-by-side: This table illustration displays typical costs with and without a common PPO dental plan.

As you can see this plan pays for itself with just routine preventative care and one minor filling. If you require any major work the savings are huge almost from the outset.

Analyzing the True Vision Insurance Cost

Vision insurance works in a similar manner but the numbers are smaller. The average vision insurance cost is less, ranging in some cases from $10 to $20 per month.

A routine eye’s examination will cost $150-$250 if no insurance is available. Most vision plans are covering a small copay to have this exam, which ranges from $10-$15.

Additionally, they offer an “allowance” for frames (ie., $150) and provide standard lenses. In the case of glasses or contacts, the plan more than pays for itself with one yearly visit and new eyewear.

The “Gotchas”: Understanding the Fine Print of Your Supplemental Dental and Vision Insurance

Now for the critical part. Not all plans are created equally and insurance companies are in business. You have to know the limitations before you sign up.

Ignoring the fine print is this quickest form of feeling ripped off. These “gotchas” can include waiting periods, annual maximums and network restrictions.

“Often patients interpret their new dental plan to cover a crown that has been needed for many months.” They are then rendered shocked with the information of a 12-month waiting period for major services. It’s not a matter of never needing to refer to an insurance policy – it’s a matter of reading the policy before you need it. — Dr. Alisha Rana, DDS

It’s extremely important to become as diligent about purchasing a supplemental dental and vision insurance plan as you would if working with your primary Life Insurance Coverage.

The Waiting Period Trap

So far this is the biggest “gotcha” of them all. A waiting period is the period of time you need to be in a plan and paying premiums before certain benefits are provided to you.

For instance, a plan may include preventive care right away. However, you might need to wait 6 months for a basic service such as filling.

Worse yet, you may be looking at 12 or even 24 months of waiting time for major services such as crowns or bridges. This prevents people purchasing insurance only when they need some expensive work and then dropping it.

Annual Maximums and Deductibles

Another important point is the annual maximum. This is the amount that your insurance plan will pay a maximum amount in any one policy year for your care.

A common and typical annual cap is between $1,000 and $2,000. If your plan has a maximum of $1500, after the insurance company has paid out that amount, you will assume responsibility for 100% of the costs until the policy year starts again.

Some policies that are marketed as full coverage dental plans may have higher maximums, perhaps $3,000 or more, but they will also have higher premiums.

You’ll also have a deductible. This is the amount of money that you are required to pay out-of-pocket before your insurance begins to cover some of the cost. It’s often around $50 to $100 per year.

Is Supplemental Dental and Vision Insurance the Right Choice for You?

So, we get to the main question. After considering the costs, benefits and limitations, who should purchase these plans?

The answer is entirely dependent on your personal situation, health history and financial situation. There is no such thing as one size fits all.

Let’s break it down depending on the stages of life and needs. This is much like comparing Term Insurance vs Whole Life Insurance; it depends on your long-term aims which one of you are suitable for.

Who Should Seriously Consider It?

You are a good candidate for supplemental dental and vision insurance if you are in one of these categories:

• Seniors on Medicare: As mentioned, Medicare almost has no coverage. Often a supplemental plan is not just a luxury, but a necessity. The National Council on Aging (NCOA) has some guides on senior health finances.
• Families with Children: Teeth will require regular check-ups, fluoride treatments, sealants and often will require orthodontics. Sometimes there are huge savings with a family plan.
• Individuals with a History of Dental Issues: Not only if you know that you have soft enamel, but also people who suffer from gum diseases or have had poor teeth that developed areas that needed crowns, a plan is a great idea from a financial standpoint.
• The Self-Employed or Gig Workers: Without being employed by an employer, you are wide open to high costs. A private plan is your insurance against anything and everything.
• Anyone Planning for the Future: So anyone planning for a whole bunch of reasons (and major work in the way of a year or two in the waiting period) it is strategic to enrol now.

Who Might Be Able to Skip It?

On the other hand, you may be able to pass on a plan, at least for now, if you tick this box:

• Young, Healthy Singles: If you have perfect teeth and 20/20 vision, and only go to the dentist once a year for cleanings, you may break even or even lose a little bit of money on premiums.
• Those with “Cadillac” Employer Plans: If your job offers you excellent, low-cost dental and vision benefits, you do not need a supplemental plan.
• Disciplined Savers with an HSA/FSA: If you’re disciplined savers with an HSA or Flexible Spending Account (FSA), then you’ve got the ability to use the tax-advantaged funds to pay the cost of your dental or vision. This is really “self-insuring.” Financial resources such as Investopedia details on these accounts.

Exploring Different Types of Plans

If you do decide to do it, you will find a few different types of plans. The two most common of these are: DPPOs and DHMOs.

A Dental Preferred Provider Organization (DPPO) provides you a network of dentists who have accepted reduced rates. You can go out of network – but your costs will be higher. This is the most popular and flexible one.

A Dental Health Maintenance Organization (DHMO) obliges you to use dentists in a narrow network. You have to select a primary care doctor and have referrals for doctors who specialize in a specific field. Such plans typically involve lower premiums with less freedom of choice.

You will also find dental vision hearing plans which include all three packages in one policy. This can be convenient to have, and sometimes more affordable than having to buy three different plans.

“It’s not just about cost when choosing and plan, it is about access. If you’ve had the same trusted family dentist for the last 15 years and he or she isn’t in a network of a particular plan, that low premium may not be worth the trade-off. Never accept that you cannot afford to go right to a provider Always check the providers directory first.” — Mark Chen, Certified Financial Planner (CFP)

How to Choose the Best Supplemental Dental and Vision Insurance

Finding the right dental and vision insurance requires some homework so that you can supplement your coverage. In which case, do not just take the cheapest option.

1. Assess Your Needs: Be honest about your dental and vision past and the need in the future.
2. Check the Network: Case in point, make a list of possible plans and immediately access whether your preferred dentists and eye doctors participate in network.
3. Read the Coverage Details: Look at the percentage covered for basic and major services. Scrutinize the waiting periods and maximums per year.
4. Compare Costs: Compare the monthly premiums, deductibles, and copaks. A higher premium placed on a plan with $2,500 maximum might be better than a cheaper plan with a $1,000 maximum.
5. Look for Value-Adds: Some plans have additional benefits such as No-Claim Bonus Health Insurance equivalent where the annual maximum increases after each year of not using the maximum.

Having a quality insurer to choose is paramount. Just as you would do a research of the Best Life Insurance Companies for their reliability, do the same for your dental provider.

The Real Cost of Neglect: Why Avoiding the Dentist is a Bad Idea

Some people are not able to afford the costs and simply opt out of dental and vision care altogether. This is a highly dangerous financial and medical strategy.

A small cavity which would have cost $200 to fix can fester for a year, and end up costing $2,000 for a root canal and crown.

Furthermore, poor oral health is associated with serious systemic health problems such as heart disease, diabetes and stroke. Your mouth gives your body access to the rest of your body.

Viewing supplemental dental and vision insurance not as a cost item, but as a tool with which you can enable preventive care can help change your perspective. It is easier to make those twice-yearly cleanings that can prevent major problems down the road.

Think of it this way – you have a plan in place in case of things go wrong with your vehicle. The process by how to file Car Insurance Claim is something you know. You need the same sort of pre-emptive plan for your health, before an emergency comes upon you. Just like you need Life Insurance, you need a plan for the health events that are not life-threatening but are financially significant.

Conclusion: The Final Verdict on Supplemental Dental and Vision Insurance

So, is supplemental dental and vision insurance worth purchasing? For most people, and especially for families and elderly people, the answer is a resounding yes. The price of premiums is often a small price to pay for protection from catastrophic and unpredictable dental and vision bills. It offers financial peace of mind as well as reward for the preventive care needed for long-term health.

The key is to do your homework. You have to know waiting periods, know annual maximums, and make sure your dentist is in-net. It’s not a magic wand which makes all costs go away. Instead, it involves a strategic financial tool made to make essential healthcare affordable and predictable.

For a relatively young, perfectly healthy person, with a good savings account, the math may not be on their side. But for all but a few, it’s this coverage that serves as a crucial bridge over the gaps left by normal health insurance coverage. Ultimately, it will be an informed decision about the supplemental dental insurance and supplemental vision insurance you and the options you will choose about your overall health and financial changes.

Frequently Asked Questions (FAQ)