Why aren’t vision and dental covered under regular medical insurance?
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When it comes to U.S. health insurance, think history, not design. The current system isn’t a single designed system so much as a patchwork of overlapping fixes.
In this case, dentistry has a peculiarly separate history from medicine. It may seem weird, but remember that barbers and surgeons used to share a discipline, and that many countries treat medicine and surgery as different fields. Likewise, opticians aren’t medical doctors.
Also, remember that traditional health insurance was like any other kind of insurance: It protected you against big unforeseen catastrophes, not regular stuff. If you suddenly ended up in the hospital, it would save you from bankruptcy. It wouldn’t do anything for your regular checkup, which was totally foreseeable and affordable. So, why would it cover regular dental checkups (which everyone needs) or a new set of glasses? These were as much your responsibility as buying groceries, paying the plumber, or getting a new pair of shoes.
I know this!
Regular health insurance is built as a major risk pool. The goal (even for Medicare) is that premiums come in and a minimal of payouts happen.
Vision and dental have a risk component built in, but operate more as a super high fee savings account. You’re buying in for a discount and a very small (relative to premiums) payout.
There are health plans like this too (not ACA accredited) that do this too. Limited benefit plans.
The most basic answer is that “Insurance” is for “really, really bad things”, not “ordinary bad things”.
Auto insurance isn’t for when you bump someone’s car while parking. It’s for a major collision where people are injured and cars destroyed. House insurance is for when your home is gone because of a fire, or a tree falls through a wall, not for when you have a small repair.
Medical expenses are regularly $10,000 and up, for a major injury, or something like an appendicitis or other minor surgery.
Vision expenses usually aren’t. A regular exam, tests, some glasses, usually a few hundred dollars, maybe $1000. Yes, that’s a lot, but not massive to where a person may never be able to pay that off. Same with dental.
And if Dental and Vision really do have issues that cost tens of thousands of dollars? They are covered in regular health care policies anyways! Opthamologists are medical doctors. Someone to treat your bone infection in your jaw is not a dentist.
Many severe vision and dental related issues are covered under regular medical insurance, it depends on the cause. My mom lost 3 teeth due to cancer and her medical insurance paid for implants
Many vision things are covered under medical insurance. Vision coverage plans cover things like glasses and contacts. However, if you have any medical problems of the eye such as cataracts, corneal abrasions, macular degeneration, glaucoma, diabetes, etc., that would be covered under medical and not vision.
The real question is why doesn’t the U.S. have national health insurance that covers *everybody* and that completely covers all medical, dental and mental health problems *completely?*
I served in the Marine Corps. We got excellent medical and dental coverage through the U.S. Navy Hospital Corps. (The Marine Corps does not have its own medics. They come from the USNHC and are called “corpsmen.”) Every regiment has an Area Sick Bay. If you need medical or dental attention you just get a sick bay pass from your company office and go there, and get treated for free. Going in for check-ups is not optional. You *will* go to sick bay when they tell you to come in for a medical or dental check-up.
I see absolutely no reason why people who wish to become physicians, or dentists, or nurses, or any other medical profession should not spend at least two-to-four years serving in a National Health Corps. Regional Class II hospitals surrounded by neighborhood clinics with air ambulance service to Class I trauma centers. Our nation’s health is a national security concern.
Medical schools are created and supported **BY SOCIETY.** Millions of people support them by going to work every day creating the society that allows modern medical science to exist. Clean water, sewer systems, electrical grids, streets and highways, safe and dependable food, etc., etc. don’t just fall out of the sky.
Our nation should be delivering medical and dental care to *every single person* at least as good as our armed forces receive.
That’s pretty easy actually.
Insurance companies are for profit businesses. In their perfect world you’d pay them without them ever having to give you any money back. Which is why it is notoriously difficult to get an insurance to pay anything, and why they’d be willing to spend hundreds of thousands on training and maintaining experts in stuff like recognizing if a house fire actually was an accident, or negligence/arson.
They’ve found that the majority of people have a pretty high chance of needing help with vision and dental at some point in life. So they don’t cover it, to keep more money for themselves.
You are getting a lot of long winded answer but really it’s just greed. Insurance companies will exclude anything they can to make more money having dental and vision separate furthers their goal.
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