Shopping for dental and vision insurance? Choices abound
07/04/2014 3:00 AM
07/04/2014 12:19 PM
Parents hate to get a notice from an insurer that their college-age child is no longer eligible for dental and vision coverage.
The Affordable Care Act requires employer-provided family health insurance plans to cover adult children until they turn 26, but there are no such guarantees for dental or vision insurance.
And more companies are dropping these benefits to help keep their health insurance costs in check. Some companies drop dependents from their plans at age 18, others when they graduate from college.
Problems also arise if your child has received dental and vision benefits through the federal insurance program COBRA, which provides protection up to 36 months. My college student son is in that situation. He was bumped off my employer plan three years ago. Now he’ll lose dental and vision insurance through COBRA at the end of July.
So prepare to go shopping to protect your 20-something’s perfect teeth and eagle-eye vision.
The good news is there are plenty of affordable coverage options, and the insurance can be bought at any time without the need to wait months for enrollment season.
If your child is in college, check university-sponsored health insurance plans first. Some but not all schools provide more than just medical benefits, which could fill your coverage gap.
Among other options, the most common is to buy separate dental and vision policies. Websites such as ehealthinsurance.com compare prices and policy details from dozens of plans.
If you have a preferred dentist or eye doctor, check on what plans that practice accepts before enrolling. And keep in mind that you can still choose a specialist that is not part of a network.
As for benefits, look for an insurer that covers regular checkups and cleanings twice a year. Vision insurance plans typically cover one regular eye exam per year along with contacts, frames and lenses up to a specific dollar amount.
Some health insurers that sell direct individual medical policies also offer dental and vision coverage as a rider, said Carrie McLean, director of customer care at eHealthInsurance.
Another option is dental and vision discount plans offered by companies such as Optum HealthAllies, which typically advertise savings of up to 50 percent on certain procedures. But these are not insurance policies.
Before you sign up, the Federal Trade Commission suggests checking on whether your dentist or eye care specialist accepts those discounts. And see how many providers within a 10-mile radius of your home accept the discounts. Your options might be limited.
Going it alone
There is another choice — skip the insurance system and pay the costs out of your own pocket. If you can handle the risks of the unexpected, this strategy may be the way to go, especially if your child has strong eyesight and a good oral health history and needs only two teeth cleanings a year.
Check with your family dentist and eye doctor about charges for basic procedures. My son’s dentist quoted a total out-of-pocket cost of about $300 a year for two exams, two cleanings and one set of X-rays.
After running the numbers, if you do choose to sign up for insurance, don’t expect the new plan to cover a root canal or Lasik surgery the next day, said McLean. In some cases, pre-authorization from the insurer is needed.
Startup dates for coverage vary. Generally, PPOs kick in on the first and 15th of the month, said McLean, but HMOs lock in the first day of the month only.
To reach Steve Rosen, call 816-234-4879 or send email to email@example.com.
Join the Discussion
The Kansas City Star is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.