Employee Benefits

5 Things to Know About Medical Benefits with Dental and Vision Coverage

Two-for-one promotions sound like good deals, but often one item is good and the second doesn’t quite match up to expectations. This analogy could be used when referring to health insurance benefit offers promoting medical insurance combined with dental and vision coverage.

To ensure the option will provide the insurance coverage to meet your needs and those of your dependents, here are five things to check:

1. Review the insurance carrier’s reputation – Make sure it’s a reputable company, one that knows how to process dental and vision claims quickly and correctly. Medical carriers are experts at processing medical claims, but may not have the systems in place to review and pay dental and vision claims promptly. Check the carrier’s history for premium increases. Explore how others rate the customer service and quality of the coverage.

2. Verify covered procedures – After enrolling in the plan, how soon can you access benefits? Does the plan require the satisfaction of an out-of-pocket deductible before covering medical, dental or vision services? If so, know the amount, when it applies and whether there is a benefit maximum. If there is a waiting period, ask whether preventive services are covered (professional cleanings and checkups) while you wait for coverage for basic or major dental work, such as fillings, root canals or crowns. Ask for details on the percentage paid by procedure category.

3. Ask about procedure and frequency limitations – Know whether the plan features frequency limitations on when X-rays can be taken and the number of years required for crown replacements. Some carriers have a five-year rule while others have a 10-year limit.

4. Explore options for in-network or out-of-network providers – A combined coverage plan may require you to receive services from a specific list of providers. This may mean you need to change your medical, dental or eye doctor if they’re not on the list. View providers in Ameritas’ network.

5. Evaluate other coverage options – Although a combined plan may look like a valid option, don’t feel pressured to make this choice. It’s OK to purchase stand-alone dental and vision insurance separate from your medical coverage. Stand-alone benefits usually are more complete:

  • Coverage for the entire family (adults and children) with the option to add orthodontia
  • Extensive dental and vision provider networks across the country
  • Plans customized to fit an employer’s needs
  • Premiums priced accurately so employers and employees avoid unexpected rate increases each year
  • Customer service and claims processing designed specifically for dental and vision services

Learn more about dental and vision benefits on ameritas.com, or get a quote for an individual plan.

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