Merritt Personal Lines Manual: Chapter 7 Dental, Vision and Prescription Drug Plans
Dental care is usually considered a budgetable expense, so it's usually not included in group health plans. However, you can usually obtain dental care from your employer in the form of employee benefits.
Some health plans do include dental coverage as part of the medical plan; others include it as a separate add-on plan. Also, many plans do provide coverage for non-cosmetic dental work resulting from an accident
Your employer may also offer direct reimbursement for dental care - this is a noninsured dental coverage plan typically used by smaller employers - in which your employer agrees to pay for a percentage or amount of the expenses. Small employers usually go this route to avoid both the costs associated with an insured plan and the administrative complexity of going through an insurance company. In addition, the risk is considerably smaller because dental expenses, unlike medical expenses, tend to be more predictable and seldom involve catastrophic expenses.
Vision coverage is similar to dental, in that it is a relatively new benefit, usually offered by employers that can afford to add certain fringe benefits typically considered budgetable.
Most health plans provide coverage for medical care related to eye injury or disease, but not for costs associated with periodic eye examinations or corrective lenses.
Vision care is typically covered on a scheduled basis that pays a fixed dollar amount for examinations, lenses and frames.
Most often, only prescription drugs that are for treatment of an illness or injury are covered by a health plan - subject to applicable deductibles and coinsurance.
Example: Your insurance company might not cover your contraceptive prescription drugs or the nicotine chewing gum you need to help you quit smoking.
Different insurance companies offer different types of drug plans, but the basic types of prescription medication plans, include open panel, closed panel, mail order and prescription drug card plans.
