By Sydney Frazer, Stride Health
As a freelancer, you are responsible for figuring out your own health insurance—choosing a plan, getting enrolled, and paying your premium. However, it goes beyond just health insurance. You must also research, select, and pay for your dental and vision insurance. It is a common misconception that health insurance includes dental and vision coverage; however, this isn’t usually the case. Dental and vision generally need to be researched, chosen, and enrolled in separately from health insurance. Cut out some of the time you would need to invest researching to try to understand dental and vision insurance by reading the rest of this guide!
3 Things to Know About Dental Insurance
1. What it is
Dental insurance is designed to reduce your costs associated with routine preventive care, as well as other necessary care that might arise throughout the year. While paying for routine preventative care like a cleaning isn’t usually too expensive without dental insurance, paying for more extensive procedures that are unpredictable like root canals and crowns can cost thousands of dollars out of pocket. Most people choose to buy dental insurance to protect themselves from these types of costs.
2. What it covers
Most plans tend to cover three levels of care: preventative and diagnostic care, basic restorative care, and major restorative care.
Preventative and diagnostic care - This is the least expensive and least time intensive of the three types of care. With that said, dental plans tend to cover a larger percentage of costs associated with preventative care, usually 100 percent! Wondering what preventative care includes? It generally includes things like cleanings and oral exams two times per year. In addition, it includes x-rays, as well as fluoride treatment for a specific subset of the population. Remember, this care is usually covered at 100 percent by your carrier, meaning these services are free to you.
Basic restorative care - This includes procedures like fillings, extractions, root canals, and emergency palliative care, as well as other basic procedures. These types of procedures generally require a bit more time on the provider’s part and are more costly. An average dental plan will cover 80 percent of these costs, leaving you to pay the remaining 20 percent.
Major restorative care - Major restorative care includes crowns, bridges, implants, dentures, and other major procedures. These kinds of procedures generally require the largest time investment on your dentist’s part and cost the most. A common dental plan will cover 50 percent of these costs, leaving you to cover the remaining 50 percent.
Be sure to keep in mind that most plans don’t cover cosmetic dental procedures. Cosmetic dental procedures include things like veneers, teeth whitening, and, usually, orthodontia. You will be required to cover all of these procedures out of your own pocket.
3. The nitty gritty
Similar to health insurance, you choose a plan network when picking dental insurance. There are three types:
Health maintenance organization (HMO) - If you choose a plan that is an HMO, you will only get coverage if you visit a dentist that is within your HMO’s network. If you see an out-of-network dentist, you will have to pay all of the costs.
Preferred provider organization (PPO) - With a PPO plan, you will receive greater coverage if you visit a doctor that is in-network. However, if you see a dentist that is out-of-network, a portion of the visit will still be covered.
Indemnity - If you get an indemnity plan, you can choose to see any dentist and a portion of the costs will be covered. This portion is usually pretty small because indemnity plans operate without networks.
3 Things to Know About Vision Insurance
1. What it is
Vision insurance is designed to reduce your costs associated with routine eye exams and prescription eyewear, as well as other necessary care that might come up. Vision insurance helps make it affordable to schedule regular eye exams. Not only can this help you identify vision correction needs, but it can also help diagnose eye diseases while they are in their early stages. Considering 66 percent of American adults need vision correction, this can really pay off.
2. What it covers
Most plans cover preventative care, as well as prescription eyewear. You can also choose plans that offer additional options for coverage.
Preventative care - Preventative care includes eye exams, vision tests, and glaucoma testing. Eye exams help identify vision problems, as well as signs of serious medical conditions like glaucoma and cataracts. Preventative care is typically covered at 100 percent, up to a specific amount, by your vision insurance company.
Prescription eyewear - Prescription eyewear includes eyeglass frames, eyeglass lenses, and contact lenses. It also typically includes lens protection and enhancements to keep your lenses safe. Prescription eyewear is usually covered at 100 percent up to a certain dollar amount.
Additional care - Additional coverage might include things like daily disposable contact lenses and corrective eye surgery like Lasik.
3. The nitty gritty
It can be confusing trying to understand what vision insurance covers versus what health care insurance covers. Just visiting an eye doctor doesn’t mean that it is covered by vision insurance and not health insurance. In fact, your health care plan will generally cover anything medical in nature, even when it comes to your eyes. This means health insurance will be billed for things like eye infections, eyelid styes, glaucoma treatment, dry eyes, retinal tears, cataracts, and diabetes.
Be sure not to mistake vision insurance plans for vision discount plans. Similar to health insurance, you will be required to pay a monthly premium for vision insurance. In contrast, vision discount plans offer discounts on vision care. While vision discount plans tend to be cheaper than vision insurance, you usually end up paying more for eye doctor visits and prescription eyewear. When evaluating your vision insurance options, make sure you are actually looking at vision insurance plans, not vision discount plans.
While finding dental and vision insurance plans might feel like extra work on top of the time you have to invest finding a health plan, remember that they can be key to you and your family’s physical and financial health.