Trade-offs between buying coverage separately or in a bundle
Why Are Dental & Vision “Excepted” Benefits?
Independent dental insurance and vision insurance are both “excepted” benefits because they are not regulated by major health legislation (such as HIPAA and the Affordable Care Act) despite covering medical benefits. Excepted benefits are viewed as supplemental benefits filling the gaps within primary medical coverage. If dental and vision benefits are included within primary medical insurance policy, they are not exempt from requirements of the Affordable Care Act and HIPAA. However, if a medical plan requires an incremental fee for dental and vision benefits and these benefits can be declined while retaining medical benefits then they are excepted even when bundled with a medical plan.
Alongside dental and vision plans, other examples of excepted benefits include travel insurance and indemnity policies such as hospital insurance and limited scope medical coverage (such as cancer insurance or critical illness insurance).
Dental and vision coverage are commonly sold as separate and independent insurance policies. Additionally, neither dental nor vision plans have standardized benefits. The implications of this state of affairs is that considerable coverage differences exist among plans. For example, one dental plan may cover only preventive and basic dental care such as fillings while a different dental plan may cover those services alongside expensive care such as crowns, root canals, and dental implants. With respect to vision plans, there can be significant differences in insurer coverage of eye exams and the amount the plan contributes toward contact lenses, glasses, and frames. For rate quotes for stand-alone vision plans, vision our Vision Plans page.
There are insurance products on the market that combine dental and vision coverage within a single plan.
Humana Extend 5000
The Humana Extend 5000 dental plan also includes vision and hearing benefits. The Humana Extend 5000 plan's dental benefits include a $5000 per calendar year maximum benefit (per insured person) for preventive, basic, and major dental services. The details of the plan's vision benefits are listed below.
The Humana Extend 2500 dental plan, like the more expensive Humana Extend 5000, packages vision and hearing benefits along with its primary dental benefits. The plan's dental coverage includes a $2500 per calendar year maximum benefit (per enrollee) for preventive, basic, and major dental care. Vision benefits are somewhat more limited than found in the Humana Extend 5000.
A quick note on dentist choice - if you use an out-of-network dentist on a PPO plan, you will likely pay higher out-of-pocket costs than would be the case for an in-network dentist. Be certain to factor those costs in if your dentist does not participate in the network for a plan you are considering.
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