Overview
Vision and dental policies are types of supplemental insurance, not substitutes for comprehensive health coverage. These policies provide additional financial protection for costs that a major medical plan may not cover fully. They may be offered by an employer as a voluntary benefit, purchased through the Marketplace, or bought individually from an insurer.
Eligibility
Dental and vision plans are available to most individuals and are frequently offered as employer add-on benefits or as standalone purchases. These plans are not a substitute for a major medical plan and don't meet ACA essential health benefit standards. This is standard for these plan types and does not affect their legitimacy as supplemental coverage.
Enrollment
Employer-sponsored supplemental plans follow the employer’s open enrollment schedule, with enrollment also available at the time of hire or during a qualifying life event. Individual dental and vision plans can be purchased year-round from private insurers or during the Marketplace Open Enrollment period for exchange-based dental plans. Availability of dental plans through the Marketplace varies by state.
Approval
Employer group supplemental plans are usually guaranteed approval during open enrollment, meaning no medical questions are asked. Dental and vision plans purchased through the Marketplace are generally guaranteed approval or require only simplified underwriting.
Typical Coverage
Dental insurance covers preventive care such as cleanings and X-rays, basic procedures like fillings and extractions, and major work including crowns and root canals. Most plans have an annual benefits cap which are commonly low enough that significant dental work may exceed your plan's benefits in a given year. Waiting periods of six to twelve months are common before major procedures are covered.
Vision insurance covers annual eye exams, lenses, frames, and contact lenses, and may include discounts on corrective procedures such as LASIK. These are typically low-premium plans with defined allowances for hardware frames and contact lenses.