Dental and vision insurance

Dental and vision insurance protect your oral and eye health by reducing out-of-pocket costs for routine care, corrective services, and unexpected treatments.

1. What Dental Insurance Typically Covers

Dental plans often include:

• Preventive care: Cleanings, exams, and x‑rays (usually fully covered)

• Basic procedures: Fillings, simple extractions, root canals

• Major procedures: Crowns, bridges, dentures, and sometimes implants (with limits or waiting periods)

• Orthodontic options: Available on some employer or premium plans, often with lifetime benefit caps

Coverage varies by plan type—PPO, HMO, or DHMO—and often involves deductibles and annual maximums.

2. What Vision Insurance Covers

Vision plans usually include:

• Annual eye exams

• Glasses or contact lenses (basic single-vision and bifocal lenses)

• Discounts on upgraded lenses or frames

• Laser correction surgery discounts from participating providers

• Limited coverage for medical eye conditions, depending on plan type

Vision insurance is designed for routine care and elective enhancements—not medical eye disease treatment.

3. Cost and Coverage Limits

• Dental plan annual maximums typically range between $1,000 and $2,000.

• Out-of-pocket cost varies: preventive care is often free, but major services may require 50% coinsurance after deductible.

• Vision benefits usually include an annual allowance of $150–$200 for lenses and frames.

• Deductibles are minor for vision and may be included in dental.

4. Limitations & Exclusions

Common exclusions include:

• Cosmetic procedures like cosmetic whitening or veneers

• Vision surgeries unrelated to refractive correction or medical necessity

• Cosmetic orthodontics

• Non-preventive dental care before initial waiting periods, often 6–12 months

• Disorders deemed “pre-existing” in a waiting period clause

5. How to Maximize Your Benefits

To get the most out of your plan:

• Use in-network providers to reduce costs

• Schedule routine dental cleaning and eye exam early in the year before deductibles or maximums reset

• Plan major dental procedures after meeting deductibles if possible

• Use FSA or HSA accounts to cover treatment costs tax-free

• Compare plan benefits before open enrollment to match your needs

Summary Table

Final Takeaway

Dental insurance covers preventive care and basic treatments, while vision insurance focuses on exams, eyeglasses, and contacts. Coverage for major dental work and vision correction has limits, caps, and waiting periods—so understanding your plan helps avoid surprises.

Need help reviewing dental or vision benefits or selecting a better plan?
With 30+ years of experience and access to nearly 100 carriers, THAgency helps you compare options and maximize your benefits—fast, personalized, and commitment-free. Send your inquiry today.