When things have been a certain way for a long time (or always), it can be a real eye-opener to stop and think about them in a different way.

We pay medical insurance (or at least part of medical insurance, if we have an employer), but if we want that insurance to cover our teeth or eyes – arguably part of our bodies that sometimes need medical attention – we have to pay extra.

CMV: Basic dental and vision should be included in all health insurance

Whether it is universal or private insurance doesn’t matter. There is no reason for them to be excluded or separate. I will be referring in terms of USA, however, because that’s the only place I have experience with.

As far as I’m aware the only reason they are often separated is because they are considered “non essential”. Your teeth and eyes are pretty damn essential. You have to eat every day, you have to see every day. You shouldn’t have enroll in a separate plan to take care of them.

I think we still need to have basic services included. Basic meaning dental exam yearly, X-rays every certain amount of years, things like cavities and chipped teeth. For vision, a yearly exam, glasses if needed, treatment for conditions luke glaucoma or cataracts, etc.

What about dental and vision care that isn’t (usually) essential like braces or contacts? They could be excluded in cheaper plan options unless medically necessary. There are cases where braces are necessary. As a child, my teeth were straight but my upper palate didn’t grow properly so I needed braces to be able to have my jaw align. That’s essential to chewing and medically necessary. Braces for cosmetic reasons could reasonably be excluded. I’m not sure if there’s any conditions where glasses won’t work and contacts are needed, but otherwise I think contacts are possible to exclude as well.

I honestly can’t think of any reason to keep them separate. If you think so, change my view.

It’s kind of crazy, when you think about it, don’t you think?

This guy does, and he’s seeing whether or not Reddit can change his view that medical insurance should cover dental and vision costs, as well.

14. It it, though?

Insurance is designed to help you cope with major unexpected costs, not for routine purchases. The system works because most people pay more in than they receive; the surplus is given to those who truly need it.

Vision care doesn’t really fit into this system because many people don’t need it at all, and those that do are getting routine care. It makes more sense to pay the provider directly for your yearly eye checkup and any glasses or contacts you wish to buy. Actual eye emergencies, such as cataracts, usually require medically-necessary treatment and are covered by medical insurance anyway.

Dental care is similar in that most people have their yearly checkup, and sometimes the occasional cavity. No one wants to pay for insurance on the off chance that they might need a root canal or braces.

Including dental and vision care with medical insurance would be like including tire repairs and car washes with car insurance. Sure, they are necessary, but they’re so common that it makes more sense to pay for it when you need it.

13. Maybe because the dentists don’t want to be included?

Okay so I’m not from US. Vision is covered under my insurance plan but dental is not covered because of mostly the history of dental cover in my country. I looked into it a while back and turns out a most countries (including USA) have wonky relationship with dental being included in healthcare.

This is because dental providers were never REALLY accepted into the health industry and had to make their own way. Their own schools, their own colleges, their own networks. There is no doctor who specializes in teeth, there are dental technicians, dentists, etc… For all intents and purposes dental is treated differently than medical almost everywhere. This ironically allowed them to unionize more effectively and they leveraged a beneficial position for themselves.

So why isn’t dental included in most standard insurance plans? Money. Because dentistry wasn’t historically treated as “real doctorism” they managed to also dodge the regulations and restrictions that healthcare workers didn’t. But because people obviously don’t want their jaw hurting all the time, they retained a steady supply of customers. Ever noticed how dental is always treated as a mark of luxury? The single addendum -dental included suddenly causes the value of service to skyrocket.

The only way to force dental under the same umbrella of insurance is via government intervention, and there you have to navigate the political and lobbying process (which is designed to make money) to force them to make less money.

It’s not about fairness. It’s not about dental not being essential to one’s health or what have you. It’s simply money.

12. Preventative care saves everyone money in the long run.

As a Canadian I would go even farther to say it should be part of a socialized health care system.

The preventative care not only prevents emergencies later down the line that would cost significantly more; it improves well being and therefore efficacy of the recipient as a member of society.

11. It doesn’t have to stay that way.

So the reason why they are separate in the U.S. at least is because of the way health insurance works. You can think of it like a group of people getting together to pool their medical expenses and then paying a fee to the insurance company to split the costs evenly among them. People in general are willing to pay for health insurance because the cost of health insurance varies wildly by person by year so paying the flat fee is more attractive.

This just doesn’t hold with vision and dental. For vision around 25% of the population just doesn’t need glasses so it really doesn’t make sense for them to buy a vision insurance plan. of the remaining 75% most have a relatively fixed cost for how much they are spending on vision care, i.e. I get one eye exam per year and two pairs of glasses whenever my prescription changes. It’s rare to encounter surprise costs. So from an economic standpoint it rarely makes sense to buy a vision plan. (In fact growing up we found it was often cheaper to buy glasses outside of our insurance network. We literally only get it every other year for the eye exams). Same deal with dental most people don’t buy dental insurance because their dental costs are fixed: 2 cleanings a year, one thing more advance every 4 years or so.

Since most people don’t feel that they need dental or vision including it in most insurance plans would just make them seem more costly and not as good a deal to most people.

10. There’s a workaround.

Kinda off topic, but if anyone reading this needs extensive dental work done GO TO MEXICO.

I just recently had around $3.5k worth of work done for $1400. My dentist in WA wanted to split the work up over multiple days “for billing purposes” and were going to have me go to an endodontist who they “don’t share x-rays or records with” so I would have to pay for x-rays multiple times. It was going to be 4 total visits for a deep cleaning, root canal, and crown.

My new dentist in Mexico got me scheduled with just 2 days notice, picked me up at the border, brought the endodontist and his team to their office, and got it done in just 2 visits. Oh, and they also did 7 fillings while they were in there. Impeccable customer service and excellent work. I’m going back for some implants asap

9. That seems complicated.

One big reason to keep them separate is that they are way cheaper than Heath insurance. With the current set up, I can (and do) have the worst insurance I can, but have good dental and vision insurance because I know I will need them yearly.

Another big reason to keep them separate is that dental and vision billing is a (as far as I am aware) as lot simpler than medical billing. Moving these companies to billing healthcare insurance would probably mean they have to hire more staff to deal with more complicated payors. Leading to more out of pocket expenses for the end user.

8. Some (smaller) things are covered by medical.

I will say though, that things like glaucoma and cataracts, diabetic eye exams, AMD, and even things like floaters in certain instances are covered under medical. Just not refractions or the glasses except for certain state programs. Which is silly, but insurance is greedy.

You should be included one pair of basic glasses per year in my opinion, if you get extras then you pay the cost of the extras out of pocket. And then regular dental exams covered with a good coverage on fillings and stuff.

But what do I know, I’m poor.

7. So, because we’re lazy…?

What reason is there to merge them together?

It would take a massive amount of effort, and wouldn’t provide that much value to the consumer.

Would having one health insurance really be that much better than having 3, if the total price is the same?

6. It’s all about the money.

Thing is, insurance is about distributing risk and also creating a system of collective bargaining against the provider.

Everyone needs dental care so there’s no way to effectively distribute risk…

And a huge majority need vision care, then all you’re doing is having the people with perfect sight subsidize the majority who don’t.

To me it makes sense that these things wouldn’t be covered in a standard plan.

5. We know we have to force employers to do the right thing.

In some cases, employers provide health insurance without providing dental or vision.

It could be cheaper to the consumer to have it covered by their employer instead of having to get it separately.

It also could stop people having to decide whether or not they should forgo dental and vision insurance.

4. They’re still expensive, though.

Something that hasn’t yet been mentioned is the ability to choose your network.

Some people have already talked about catastrophic policies, but by having separate vision / dental / medical plans you actually give consumers more options to select a plan that includes the doctors they want to see.

3. Some people don’t want to pay for it.

Many people just want catastrophic insurance – cheap insurance that only kicks in for expensive stuff you can’t afford out of pocket.

Like why pay a company to tell your doctor what you can and can’t have – insurance middlemen add a lot of expenses. They’re just good for expenses you can’t save up for.

Dental and vision problems that aren’t covered by health insurance tend to be cheap enough for many people to cover with an emergency fund or payment plan.

For them, insurance would just add expense and hassle.

2. More than basic dental costs $$$ though.

Basic dental would be two cleanings a year and x-rays, and basic vision would be an eye exam. How much do these things cost if you were paying for them cash?

Cost of an eye exam? $200

Cost of basic dental visit? $250

Total yearly cost for basic vision and dental $700. I suspect for most people that cost would not warrant paying for insurance.

Now, you might get more people to agree with you if you said catastrophic dental and catastrophic vision should be included with insurance. But maybe that is just me thinking out loud.

1. It’s more complicated than it sounds.

I broadly agree with the idea, but you can end up with services included that are too basic. The NHS in the UK includes dental services but in a pretty poor way, way dentists have to claim for NHS work they have done at a few fixed price levels regardless of where they are located (obviously rent on a central London practice is higher than most places etc).

This has a couple of consequences:.

NHS dentists never perform expensive procedures that a tooth crown, even where it is required, because they can’t cover the costs with the reimbursement scheme. This means often necessary procedures aren’t covered and people either have to go private anyway or put up without them.
in some areas it is really hard to find an NHS dentist and you could have to wait months on a waiting list to join a practice.

This I think would be the problem with your “basic” services, people will not provide them quickly enough or cover procedures they deem necessary for a patient, leading them to have to pay out their own pocket anyway or put up with toothache for weeks.

I think most of us agree with this – except for the insurance companies, I suppose.

How much would it help you out to have your glasses and dental expenses covered? Sound off in the comments!