Posted April 23, 2014
You and your family need flexible dental and vision coverage that can be tailored to your needs. Benefit surveys show that people who have dental and vision coverage are likely to schedule regular checkups and exams so doctors can evaluate the health of their teeth and eyes. They can also develop a treatment plan to address any concerns.
Family care and essential health benefits
The Affordable Care Act (ACA) has focused on the distinct needs of family members with the requirement of Essential Health Benefits (EHB) for small employers that include pediatric dental and vision. Some medical plans may exclude pediatric dental. But in most cases, EHB plans from medical carriers cover only pediatric family members, leaving adults to purchase any dental and vision plans for themselves and their dependents (age 19 and older) separately. Pediatric dental and vision benefits included in medical plans may be subject to large medical deductibles and out-of-pocket maximums, resulting in little actual benefits received.
Many dental and vision needs
In most families, members have different needs for dental and vision care.
- Dependents age 19 and older may need LASIK, or the option of purchasing new eyeglasses annually, or teeth whitening coverage; or all of this in addition to their routine dental and vision exams.
- Adults often experience changes in their oral and vision health as they age, which may require services beyond preventive care to help them enjoy good overall health in their senior years.
- Children may need additional dental coverage for cosmetic orthodontia; EHB plans will only cover medically necessary orthodontia such as cleft-palate conditions.
The Atlantic magazine recently reported that 77 million people have problems comprehending common health-related reading material. Employers should invest time to educate employees about their dental and vision coverage options within the ACA, underscoring the importance of these benefits to their overall health. What’s offered through the ACA may not be enough to handle the needs of a growing family, especially if unexpected dental or vision needs arise.
Dental and vision plan choices within the Affordable Care Act are explored in more detail in “For Dental and Vision Benefits, Choice Is Still an Option.”