Individual Dental/Vision

The above link will open a new page to an Individual Dental/Vision plan offered by Renaissance Dental with Vision offered through the VSP Vision Plan. The enrollment portal is managed by a firm called Morgan White. You will need your date of birth and zip code to produce a quote.  You do not have to "create an account" or "log in" - which is always an annoyance. If you like what you see, you can continue enrolling and at that point will need to provide all your information.

Why Renaissance? Mostly because I know many of the people involved in the company and trust them to put forward a quality product and stand by their promises.  But mostly because they provide a good product - a rarity in the individual marketplace.

They differ from most individual carriers as they do not have any waiting periods, although coverage is better in year 2 than year 1 (and even better in year 3).  However, it is not a DHMO plan, like many individual programs, nor is it a Discount plan.  It is a full feature PPO program with Orthodontia.   

Please contact me for other options available for individuals. Additionally, I can provide group dental plans for employers with at least 2 or more employees - and there are many more options available to small business through Koontz Insurance Consulting Group. Below I've provided some information on dental plans and some information you might need to choose the right plan. The link above will also provide information on the network of dentists. Please be sure to review the network prior to enrolling to ensure your dentist is participating.

Why Should I Have Dental Insurance?

Professional dental care can diagnose or help prevent common dental problems including toothache, inflamed gums, tooth decay, bad breath and dry mouth. If conditions like these remain untreated, they can worsen into painful and expensive problems such as gum disease or even tooth loss. According to the American Dental Association, more than 16 million children in the United States suffer from untreated tooth decay, which is the most common chronic childhood disease. Regular dental exams can not only treat dental problems but can also identify other serious health concerns, including some types of cancer. Dental coverage will allow you to inexpensively receive preventive and diagnostic care.

The Following is general information and does not necessarily reflect any specific plan:

What Dental Services Are Typically Covered?

Dental coverage focuses on preventive and diagnostic procedures in an effort to avoid more expensive services associated with dental disease and surgery. The type of service or procedure received determines the amount of coverage for each visit. Each type of service fits into a class of services according to complexity and cost. Services are generally broken up into the following classes:

      Class I – diagnostic and preventive care (cleanings, exams, X-rays)

      Class II – basic care and procedures (fillings, root canals)

      Class III – major care and procedures (crowns, bridges, dentures)

      Class IV – orthodontia (braces)

Because dental coverage typically focuses on preventive care, Class I services are covered at the highest percentage. Class II services are then covered at a slightly lower percentage, followed by Class III services, which are covered at the lowest level. For example, if a plan follows an “100-80-50” structure, Class I services are covered at 100 percent, Class II at 80 percent and Class III at 50 percent.

Class IV services are frequently covered under a separate lifetime maximum (instead of the annual maximum) and often limit coverage to children under the age of 19.

In addition to the class of service, coverage also depends on other factors. Several common services are limited by frequency. For example, most plans will only cover two cleanings and exams per year. For more complicated procedures or surgeries, coverage is often limited to a maximum dollar amount, such as $1,200 per year. Age is yet another factor that determines coverage. For example, fluoride treatments are typically covered for children, but not adults. Cosmetic procedures, such as teeth-whitening, are rarely covered.

How Does Dental Insurance Work?

Dental coverage works similarly to a medical insurance plan. You pay premiums, and then the insurance will cover dental costs according to the benefits listed in the plan. The routine exams and cleanings are usually covered at 100 percent, but other services are often subject to a deductible and copay. The deductible is the amount you must pay before your insurance will pay. After you meet your deductible, you may be responsible for a copayment or coinsurance, which is the percentage of the treatment cost that you pay. For example, if the insurance covers a filling at 80 percent and you have already met your deductible, you would only have to pay the other 20 percent of the charge. Every plan is different, so you will need to read your benefit information carefully to understand your coverage.

Some dental plans, usually individual plans, enforce a waiting period. This waiting period means you will not have coverage for certain services (usually Class III procedures) until you have had the plan for a designated amount of time, such as six months. Waiting periods prevent a person from purchasing insurance shortly before major dental surgery and then dropping coverage as soon as the policy expires.  Keep in mind the plans above through Renaissance Dental do not have waiting periods, but have a tiered benefit approach, where coverage for Class II and Class III services get better each year.

Why Should I Have Vision Insurance?

According to Gallup, approximately 70 percent of adult Americans report wearing some type of corrective lenses. A visit with your eye doctor can determine whether you need corrective lenses and, if so, the correct prescription. Other eye concerns that will be addressed in an eye exam include checking for conditions or diseases such as glaucoma and cataracts, which can lead to vision loss.

Regular eye exams can also identify overall health concerns, such as diabetes, high cholesterol and risk of heart disease or stroke before you are even aware of any symptoms. You can then follow up with a medical doctor, minimizing the effects of these conditions on your health and finances.

What Is Covered Under Vision Insurance?

Vision insurance generally provides coverage for basic care and eyewear. Most vision plans will cover the following services:

      Annual or biannual eye exams, including dilation

      Eyeglass frames

      Eyeglass lenses

      Contact lenses

Some plans may also cover other services, including laser vision care programs or even prescription protective eyewear that is compliant with ANSI and OSHA safety guidelines.

Vision plans typically do not cover replacements for frames, eyeglass lenses or contact lenses, medical or surgical treatment, vision training or experimental vision services or treatments.

How Does Vision Insurance Work?

For vision coverage, you pay a premium or membership fee. Then, when you visit your eye doctor or purchase corrective lenses, you pay a reduced amount for services. Eye exams will typically be covered at 100 percent or have a small copay. Corrective lenses are usually covered with a copay or a maximum allotted amount per year. If you are given an allotted amount, you would only have to pay if the eyewear exceeds that amount. For example, if your insurance covers eyeglass frames up to $130 and the frames cost $160, you would only have to pay the additional $30. Other services, such as eye surgery or treatment for eye diseases, are usually covered at a reduced rate.  

Most plans will place limits on their coverage for eyewear. For example, a plan might cover a new set of eyeglass lenses once a year, eyeglass frames once every two years and contact lenses once a year. Many plans will further limit coverage to either eyeglasses or contact lenses during a plan year. Plans vary, so make sure you read your benefit information carefully.