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Dental & Vision

Having dental insurance isn't the same as having the right dental insurance.

These plans look almost identical from the outside. They behave very differently once you use them.

Dental and vision are the plans people put least thought into and complain about most. Usually for the same reason: the plan was chosen on price, and the difference only showed up at the dentist’s desk.

The good news is there are only a handful of things to check. Here they are.

What is it?

Dental and vision plans cover routine care that medical plans often leave out for adults — cleanings, fillings, crowns, eye exams, glasses and contact lenses.

They can come as standalone plans you buy yourself, as part of an employer’s benefits package, or bundled into certain other plans. Wherever it comes from, the things worth checking are the same.

Who might it be for?

Worth a look if:

  • Your medical plan does not include routine dental or vision care.
  • You are on Original Medicare, which generally does not cover routine dental or vision.
  • You have a plan and have never checked whether your dentist takes it.
  • You have work coming up and want to know what will actually be paid.
  • You are a business owner adding these for your team.

What differs between plans?

Six things. These are where the real differences live:

  • Premiums

    What you pay monthly. The least useful number on its own, and the one most people choose on.

  • Networks

    Which dentists, optometrists and practices the plan has agreements with.

    Worth knowing: This is the first thing to check, before anything else. Call your own dentist’s office and ask whether they take the specific plan — not the company, the plan. It takes two minutes and prevents most of the disappointment.

  • Deductibles

    What you pay yourself before the plan begins paying its share. Some plans waive it for preventive care.

  • Annual maximums

    The most the plan will pay toward your care in a year. Dental plans very commonly have one, and it is often reached faster than people expect if major work is needed.

    Worth knowing: This is the number that decides what a crown or a bridge really costs you.

  • Waiting periods

    A stretch of time after the plan starts before certain benefits become available — frequently applied to major work rather than cleanings.

    Worth knowing: If you already know you need something done, the waiting period is the detail that matters most.

  • Coverage percentages and benefit schedules

    How much the plan pays for each category of treatment. Preventive, basic and major work are typically covered at different rates, and some plans pay set amounts per procedure rather than a percentage.

The point of this page

Two plans at nearly the same monthly price can differ enormously once you need a crown, or once you discover your dentist is out of network. The plan is not the premium. It is the network, the maximum, the waiting periods and the percentages taken together — and those are easy to compare once someone shows you where to look.

What should I know or consider?

Before you choose:

  • Start with your dentist and your optometrist. If you want to keep them, that narrows the field before you look at anything else.
  • Think about the next twelve months, not the last twelve. Any work you already know is coming changes which plan makes sense.
  • Read the annual maximum next to the cost of the work you expect. That comparison is the whole decision for many people.
  • Check whether preventive care counts toward the maximum. It varies.
  • If it is offered at work, it is usually worth comparing against what you could buy yourself — sometimes the group plan wins easily, sometimes it does not.
Take a moment

Four questions about dental and vision

Quick, nothing scored. Dental and vision plans vary more than people expect, and these are the four things that actually differ.

  1. 1 of 4 Do you have dental cover at the moment?
  2. 2 of 4 Which of these have you come across?
  3. 3 of 4 What would you most want it to cover?
  4. 4 of 4 Would you want your own dentist checked against the network?

Having dental insurance and having the right dental insurance are different things. These four questions are how you tell them apart.

Book a time — and I will have your answers in front of me

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