Dental and vision insurance is a single insurance plan that includes coverage for both dental services and vision care. Traditional medical insurance does not include coverage for typical oral health procedures or glasses and contacts. As a result, consumers must buy separate insurance for these. The good news is that new products are on the market that combine dental and vision benefits within a single plan, making coverage simpler and saving money.
Need dental insurance and wondering when you can enroll? We can tell you:
The short answer to this question is that it depends on the type of dental insurance you have. If you purchased (or are planning to purchase) dental insurance on your own without help from an employer or union, you have “private dental insurance.” Private dental insurance does not have an open enrollment period, which means you can buy this coverage at any time during the year. If you are buying single coverage for yourself, it is known as “individual dental insurance.” If, on the other hand, you are buying coverage for yourself and a spouse or child, it is known as “family dental insurance.”
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If you receive your dental coverage as benefit through your job, then you are likely in a group dental insurance plan. A group dental insurance plan does have an open enrollment period when eligible workers may enroll or disenroll in coverage. There may be only one dental insurance option since this is determined by your employer. The enrollment period for group dental insurance is often in November so it gives the employer and his insurance partner time to process the paperwork for coverage beginning January 1st of the following year. New employees, however, are given the opportunity to enroll in coverage outside of the enrollment period.
In some cases, a person may have a dental insurance through work and indemnity dental coverage purchased privately. The indemnity coverage, in this case, would pay toward out-of-pocket costs not covered by the traditional insurance provided by an employer.
Affordable Care Act dental insurance is sold on an exchange, which we will explain in the section below along with the restrictions on when a person may enroll in this coverage.
A dental exchange is an online marketplace for dental insurance plans. Brokers, for example, may offer dental plans from multiple insurance companies in their exchanges. A dental exchange on a particular insurance company’s website, in contrast, will normally restrict plan options to those produced by the insurance company owning the website.
The government’s Healthcare.gov also offers dental plans. Plans sold on this website are sometimes referred to as marketplace dental insurance. These are not all the dental plans available in a state but, rather, dental plans that specifically wanted to be listed on Healthcare.gov. The annual enrollment period for dental insurance on Healthcare.gov begins on November 1 and lasts through January 15.
There are two different types of dental insurance offered on Healthcare.gov, “high” and “low.” The dental plans labeled as high have more expensive monthly premiums. However, these plans come with lower out-of-pocket costs for the dental services they cover. Consequently, these plans are a better choice for people that use many dental services or services with very high costs. If a person uses few dental services in a year, the low plan may be a better option. Dental plans labeled low on Healthcare.gov have lower premiums but higher out-of-pocket costs.
If you buy a dental plan on Healthcare.gov, make certain it is a stand-alone dental plan since some of the plans offer their dental benefits as part of a larger health insurance plan.
If you purchased private dental insurance, you may switch your existing dental plan’s coverage and buy a new policy to begin after the old plan’s coverage discontinues. To leave you’re plan, you should call the insurance company’s customer service department. Since a private dental insurance plan does not have an open enrollment period, you can enroll any time of year. However, different plans have different rules regarding how quickly a new plan’s coverage becomes effective for use.
If you have your dental coverage through a group plan at work, you must wait until your company has its open enrollment period for benefit selection unless you recently had a life event (marriage, move to a new area, birth of a child, etc.) that may qualify you for a special enrollment period.
If you have a Healthcare.gov dental plan and wish to change plans, you must wait for the next annual enrollment period. This period happens once a year (it begins on November 1st). People can take advantage of a Special Enrollment Period outside of the Annual Enrollment if they experienced a qualifying life event such as moving, getting married, or having a baby.
Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.
