Individual Dental and Vision Insurance

The gap in most health plans

Individual health plans sold in Washington generally include pediatric dental and vision, because that is an essential health benefit for children. Adult dental and vision are a different matter. If you are an adult on an individual plan, there is a good chance your routine cleanings, exams and glasses are not covered at all.

Standalone dental and vision policies cover that gap for a relatively small monthly premium.

You are not locked to an enrollment window

This is the practical advantage worth knowing. Standalone dental and vision plans are generally available year round, without needing a qualifying life event. If you missed open enrollment for medical, you can still put dental and vision in place today.

What dental plans typically cover

• Preventive care such as cleanings, exams and x-rays, often at no cost to you
• Basic work such as fillings and simple extractions, usually with coinsurance
• Major work such as crowns, bridges and dentures, usually with a waiting period
• Orthodontia on some plans, more often for children than adults

Watch two numbers: the annual maximum, which is what the plan will pay in a year, and the waiting period before major work is covered. A plan with a low premium and a twelve-month wait on crowns is not a bargain if you need a crown in March.

What vision plans typically cover

An annual exam, an allowance toward frames on a set schedule, lens coverage with options for progressives and coatings, and a contact allowance in place of frames. Many also include a discount on elective correction procedures through the carrier’s network.

Worth checking before you buy

Confirm your dentist and optometrist participate in the network before enrolling. Out-of-network benefits on these plans are usually much weaker, and switching providers is a real cost that does not show up on the rate sheet. We check this for you as part of the quote.

If you also need medical coverage, see individual health insurance, and if you are an employer looking at group versions, see group dental.