Why teeth and eyes need separate insurance, typical costs, and cheaper options like dental schools and health centers.
In the US, regular health insurance usually does not cover adult dental care or glasses. These are separate plans.
Dental insurance
Employers often offer a dental plan you add for a small monthly premium.
Marketplace plans must cover children's dental care. Adults can buy a separate dental plan there.
Most dental plans pay for preventive care (two cleanings and check-ups a year, X-rays) at or near 100%. Basic care like fillings is often covered at a lower share, and major care like crowns at around half.
Many dental plans have a yearly maximum, often between $1,000 and $2,000. After that, you pay everything.
Some plans have a waiting period of months before they pay for bigger work.
Eye care
An optometrist does eye exams and prescribes glasses and contact lenses. An ophthalmologist is a medical doctor for eye diseases and surgery.
Vision plans usually cover one exam a year and part of the cost of glasses or contacts.
Eye diseases and injuries (an infection, an eye injury) are usually covered by your regular health insurance, not the vision plan.
Glasses prices vary widely. Ask for your prescription, including the pupillary distance (PD). By federal rule, the eye doctor must give you your glasses prescription after the exam, so you can buy glasses anywhere, including online.
Lower-cost options
Dental schools: students treat patients under supervision for lower prices. Visits take longer.
Dental hygiene schools at community colleges: low-cost cleanings.
Community health centers: many offer dental care on a sliding fee scale (price based on income). Search findahealthcenter.hrsa.gov.
Your school: some universities have a student dental plan or clinic.
Ask about a cash price. Many dentists offer discounts if you pay without insurance, or an in-house membership plan.
Before treatment
1
Ask for a treatment plan with the price of each item in writing.
2
Ask your plan for a pre-treatment estimate for big work.
3
If the price is high, get a second opinion.
Dental emergencies
For a knocked-out tooth or severe tooth pain, call a dentist the same day; many keep emergency slots. Go to the ER for swelling of the face or neck, fever, or trouble breathing or swallowing.
Common mistakes
Skipping cleanings. Small problems become expensive.
Starting big work just before your yearly maximum runs out without asking for an estimate.