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Dental Insurance and Vision Insurance: Where Quality Meets Affordability Through the Marketplace

Examinations using dental insurance and vision insurance
Topics Covered

You’ve got your health covered (a top priority), but what about your eyes and teeth?

You can buy dental and vision insurance separately or together through the Marketplace.

But, many believe dental and vision insurance are luxuries that are hard to find. Yet, the challenge isn’t availability it is knowing how to find them.

With years of navigating the Marketplace, we’re here to ensure you have the knowledge to find those plans.

Marketplace America works with many companies that offer dental and vision insurance. This means we can be an essential resource for those looking for more information.

Key Takeaway(s)

  • Dental insurance covers dental care, including cleanings, x-rays, and fillings.
  • Vision insurance covers vision care, such as eye exams and glasses.

Let’s get started in helping you understand that…

You can get both dental and vision insurance through the Health Insurance Marketplace.

If you have a dental or vision plan through your job, you can keep that plan even if you get health insurance through the Marketplace. You can also buy a standalone dental or vision plan through provided HealthCare.gov plans.

If you don’t have dental or vision coverage now and decide not to get it when you enroll in a health insurance plan through the Marketplace, you can’t add it later unless you qualify for a Special Enrollment Period.

If you’re looking for health insurance that includes dental and vision coverage, you’ll need to purchase a policy that offers this type of coverage. Some health insurance plans offered through the Health Insurance Marketplace include dental and vision coverage, while others do not. It’s important to carefully review each policy and its coverage options before making a decision.

Understanding Dental Insurance

Dental insurance typically covers preventive care, such as routine cleanings and exams, as well as basic procedures like fillings and x-rays. More extensive procedures, such as root canals or crowns, may require additional coverage or have higher out-of-pocket costs.

Many dental insurance plans operate on a network basis, meaning you’ll have access to a larger pool of dentists if you choose providers in the plan’s network. Out-of-network dentists may still be covered under certain plans but usually at a lower rate.

When considering purchasing dental insurance through the Marketplace, it’s important to understand what services are covered and any limitations or exclusions that may apply. You may also want to consider the cost of monthly premiums, deductibles, and out-of-pocket expenses when comparing plans.

Understanding Vision Insurance

Vision insurance typically covers annual eye exams and a portion of the cost of glasses or contact lenses. Some plans may also cover other vision-related services, such as laser eye surgery.

Similar to dental insurance, vision insurance plans may have networks of providers that offer discounted rates for services. It’s important to check which providers are in the network before enrolling in a plan if you have a preferred eye doctor.

When considering purchasing vision insurance through the Marketplace, be sure to review the coverage options and any restrictions or limitations that may apply. You’ll also want to compare costs such as monthly premiums, deductibles, and out-of-pocket expenses between plans.

Dental Insurance

Dental insurance is not considered an essential health benefit under the Affordable Care Act (ACA). This means that it is not required to be offered by all health plans in the Marketplace, but some do offer it as an additional coverage option. If a plan offers dental coverage, it will typically fall into one of the following categories:

Preventive care:

  • This type of coverage includes routine preventive services such as cleanings, exams, and X-rays. These services are usually covered at 100%, meaning there is no cost to you.

Basic care:

  • This type of coverage includes basic procedures like fillings and extractions. Some plans may cover these services at a percentage, while others may require you to pay a copayment or coinsurance.

Major care:

  • This type of coverage includes more extensive procedures like root canals and crowns. Similar to basic care, some plans may cover these services at a percentage, while others may require a copayment or coinsurance.

Vision Insurance

Vision insurance is also not considered an essential health benefit under the ACA, but like dental insurance, it can be purchased as an additional coverage option through the Marketplace.

Vision plans typically cover services such as eye exams, glasses, and contact lenses. Similar to dental coverage, vision plans may also have different levels of coverage or require you to pay a copayment or coinsurance for certain services.

Bundled Plans

Some insurance companies offer bundled dental and vision plans. This can provide convenience and potentially save you money.

With a bundled plan, you may have more comprehensive coverage for both dental and vision care at a lower cost than purchasing separate plans.

Additionally, some Marketplace plans may offer discounts or subsidies for bundled dental and vision coverage.

Be sure to research all of your options when selecting insurance through the Marketplace.

How to purchase dental and vision plans

There are a few different ways to get dental and vision coverage through the marketplace.

You can buy a standalone dental or vision plan, or you can add dental or vision coverage to a health insurance plan. You can also get dental and vision coverage through a Medicare Advantage Plan.

If you have a health insurance plan that doesn’t cover dental or vision, you may be able to add on a standalone dental or vision plan. These plans are offered by some insurers, but not all. And they don’t typically cover as much as a dental or vision plan that’s part of a health insurance plan.

If you have a Medicare Advantage Plan, you may be able to get dental and vision coverage through the plan. These plans are offered by some insurers, but not all. And they don’t typically cover as much as a dental or vision plan that’s part of a health insurance plan.

If you buy a standalone dental or vision plan, or add dental or vision coverage to a health insurance plan, you’ll pay a separate monthly premium for the coverage. The amount you pay will depend on the insurer, the type of plan, and the level of coverage.

You may also have to pay out-of-pocket costs for dental and vision care, even if you have insurance. These costs can include things like deductibles, copayments, and coinsurance.

Dental and vision coverage through the marketplace is not required by the Affordable Care Act. But, if you don’t have dental or vision coverage, you may have to pay a tax penalty.

If you want to get dental or vision coverage through the marketplace, you can start by looking at HealthCare.gov plans offered in your state. You can also contact a local agent or broker, by calling Marketplace America at (864) 507-5373 for more information.

Companies Marketplace America Works With for dental and vision plans

Dental

  • Alabama: Best Life, Guardian, Truassure
  • Georgia: Best Life, Guardian, Truassure, Blue Cross Blue Shield
  • Florida: Best Life, Guardian
  • Louisiana: Best Life, Guardian
  • Mississippi: Best Life, Guardian, Blue Cross Blue Shield
  • North Carolina: Best Life, Guardian, Truassure
  • South Carolina: Best Life, Guardian, Truassure, Blue Cross Blue Shield
  • Tennessee: Best Life, Guardian, Truassure, Blue Cross Blue Shield
  • Texas: Best Life, Guardian, Blue Cross Blue Shield

Vision

  • EyeMed and VSP for all states listed above

FAQ: Answering Your Dental Insurance And Vision Insurance Questions

What is the best dental insurance?

The best dental insurance for you will depend on your individual needs and budget. However, some of the most popular and highly-rated dental insurance plans include:

  • Delta Dental
  • MetLife
  • United Concordia
  • Aetna
  • Cigna

What insurance is used for vision?

EyeMed and VSP are two of the most popular vision insurance providers. They offer a variety of vision plans, including plans that cover:

  • Eye exams
  • Glasses and contact lenses
  • LASIK surgery
 

How much does most dental insurance cover?

Most dental insurance plans cover 80% of the cost of preventive care and 50% of the cost of major services. However, the specific amount of coverage you receive will vary depending on your plan.

What is the most dental insurance will cover?

The most dental insurance will cover is typically 80% of the cost of preventive care and 50% of the cost of major services. However, some plans may offer more coverage for certain services, such as orthodontics.

To find out the specific coverage details of a dental insurance plan, you should review the plan’s brochure or contact the insurance company directly.

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