Need combo dental & vision plan in CA

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madbrain
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Need combo dental & vision plan in CA

Post by madbrain »

Edited 6/20, since the details in the original post below confused many posters.

I'm looking for an insurance plan in California to take effect on August 1 that :
1) combines dental and vision coverage under a single plan - not separate or add-on policies
2) has the lowest possible out of pocket costs (deductible, copays, coinsurance)
3) has the shortest or no waiting periods for services
4) is priced at any premium level, as a third party will be paying the premiums, not me. Since higher-premium plans tend to have more generous benefits, I'm in effect looking for the plan with the highest possible premium, not the lowest as most people usually do.

So far, I have only found one plan that meets criteria 1), issued by SureBridge under the name Prime PVDH.
Does anyone else write combo policies for dental/vision in CA ?
madbrain originally wrote: My former employer federal COBRA coverage is ending in 6 weeks. Due to unemployment/income and certain medical conditions, the state will continue to pay for my medical/dental/vision coverage under the HIPP program, within certain limits, even after the 18 months of COBRA expire. I need to choose new medical/dental/vision coverage to start in August. I have the medical part taken care of, which is the most important - Kaiser Cal-COBRA coverage is the best choice, clearly, and I already have the proper enrollment forms from my ensurer along with the price.

Cal-COBRA doesn't apply to dental and vision, however. For these, the state HIPP program has a requirement that this needs to be a combo plan from a single insurer. My current dental coverage is with Delta, and the vision coverage is with Metlife VSP. Most insurers that offer both dental and vision coverage have these listed as separate plans, not combo. If the plans are separate, as opposed to combo, the state HIPP program will cover only the dental premium, but not the vision premium. I unfortunately have significant vision issues with rapid changes, and would thus really like to have vision coverage. The state will pay for premiums, but not for any out-of-pocket costs, such as copays or coinsurance, and thus, the perverse financial incentive of this program is for me to choose coverage with the highest amount of benefits, with correspondingly highest premiums. The only plan I have found so far that combines dental & vision is the Surebridge Prime DVH plan. Does anyone know of any other combo dental/vision plan ? My searches so far have not been successful. Any help would be appreciated.
Last edited by madbrain on Mon Jun 20, 2022 9:20 pm, edited 3 times in total.
sport
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Re: Need combo dental & vision plan in CA

Post by sport »

Are you sure you need dental insurance? In my experience, the coverage is limited, such as $1500 per year. So, if you incur any large expenses, the insurance only pays a small part. In addition, unless the dentist is in their network, they pay much less than the amount billed. For example, if the bill for a filling is $200, they will allow $120, and then pay 50% of that ($60). If you have not reached the $50 deductible, then they pay $10. We have had dental insurance and we dropped it because we usually paid more in premiums than the benefits we received. Of course, it is designed to work that way.

I tell people that it is "backwards insurance". They pay for small charges which I can easily afford to pay, while they don't cover large charges when I could really use some insurance.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

I'm familiar with how dental insurance works. The one I currently have is from a FAANG, doesn't have any deductible or waiting periods, the benefits are very generous, and i have been seeing an in network dentist. Almost all my procedures have had $0 out of pocket cost. The state has been paying the COBRA premiums, not me. The 18 months are up, and I can't continue the policy beyond that. I'm looking for the next best thing. And again, I will pay $0 in premiums, so unless the new plan is completely worthless, there is no question for me to decide whether it's worth signing up.
Caliscotsman
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Re: Need combo dental & vision plan in CA

Post by Caliscotsman »

FWIW

We, wife and I, pay $65 for the Delta Dental program. That suits us.

We feel we don't need vision and out of pocket suits us.

However if your situation on vision differs I empathize and will follow this thread.

I've heard Costco has access to some good plans and free prescriptions?
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

Caliscotsman wrote: Fri Jun 17, 2022 7:52 pm FWIW

We, wife and I, pay $65 for the Delta Dental program. That suits us.

We feel we don't need vision and out of pocket suits us.

However if your situation on vision differs I empathize and will follow this thread.

I've heard Costco has access to some good plans and free prescriptions?
I have macular degeneration, so, yes, my vision situation differs.
I have already been shopping at Costco for glasses and utilizing my vision coverage there. I have not shopped for insurance there, though. I will take a look.

Prescription drugs (not vision) are covered by my medical insurance, and not of concern in this thread.

I just checked with Delta dental - they offer two plans, one basic, one premium, but vision is not included with either one.

Delta Dental also has a 6 months wait for most services even with the premium plan, which doesn't make sense with no break in coverage and staying with the same dental insurer.
Last edited by madbrain on Sun Jun 19, 2022 11:07 pm, edited 1 time in total.
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Jazztonight
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Re: Need combo dental & vision plan in CA

Post by Jazztonight »

sport wrote: Fri Jun 17, 2022 4:36 pm Are you sure you need dental insurance? In my experience, the coverage is limited, such as $1500 per year. So, if you incur any large expenses, the insurance only pays a small part. In addition, unless the dentist is in their network, they pay much less than the amount billed. For example, if the bill for a filling is $200, they will allow $120, and then pay 50% of that ($60). If you have not reached the $50 deductible, then they pay $10. We have had dental insurance and we dropped it because we usually paid more in premiums than the benefits we received. Of course, it is designed to work that way.

I tell people that it is "backwards insurance". They pay for small charges which I can easily afford to pay, while they don't cover large charges when I could really use some insurance.
That's been my experience as well. The cheap dental insurance you can get through Costco (I've had it) is the same as what Kaiser now offers as part of its Medicare package. You are severely limited in which practitioners you visit. You may have had "premium" dental insurance with your previous employer, but that's gone now and would cost a lot to duplicate on your own.

Yes, with the low-cost dental plan you'll get a yearly checkup and some "free" X-rays. But the coverage is really limited.

Macular degeneration (I know what it is) is not going to be helped much with vision insurance--it's a medical condition, and you'll already be seeing your ophthalmologist for that. The vision insurance may provide some discounts for glasses, but you can get glasses anywhere, from Costco or online, for lower cost than the places that will accept the vision plan. (I used to be in the business.)

Personally, I'm beginning to see what a scam these types of insurance are, and am more and more convinced they're just not worth it.
"What does not destroy me, makes me stronger." Nietzsche
SuzBanyan
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Re: Need combo dental & vision plan in CA

Post by SuzBanyan »

Both Aetna and United Healthcare appear to offer vision plans as add-on policies to individual dental coverage. I don’t know if either is available in your state. Have you considered working with an agent?
VTS3X
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Re: Need combo dental & vision plan in CA

Post by VTS3X »

Your medical insurance will likely cover eye exams (with a contracting provider) for a medical condition, such as macular degeneration. It just wouldn’t likely cover glasses or refraction. If it’s a copay plan it will likely be your specialist copay and you may owe additional for special testing, but you would with vision insurance anyway since that usually only covers routine exams and glasses. If it’s high deductible you should get the contracted rate if your provider takes your plan. Worth checking what your medical insurance covers if your eye care provider takes your medical insurance.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

Jazztonight wrote: Sat Jun 18, 2022 6:47 pm You may have had "premium" dental insurance with your previous employer, but that's gone now and would cost a lot to duplicate on your own.
It's not gone yet, actually. I agree replacing it may cost a lot, but since I won't be the one paying for the premium, "a lot" isn't a problem. Finding a policy with good benefits still seems to be a problem, though.
Macular degeneration (I know what it is) is not going to be helped much with vision insurance--it's a medical condition, and you'll already be seeing your ophthalmologist for that. The vision insurance may provide some discounts for glasses, but you can get glasses anywhere, from Costco or
online, for lower cost than the places that will accept the vision plan. (I used to be in the business.)
Well, it means my vision is declining, and I need new glasses frequently enough. My VSP coverage provides for 2 pairs of glasses a year. I did buy them at Costco already, as they accepted VSP, and in fact the policy had specific additional discounts for using Costco.
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Re: Need combo dental & vision plan in CA

Post by tj »

madbrain wrote: Sun Jun 19, 2022 10:52 pm
Jazztonight wrote: Sat Jun 18, 2022 6:47 pm You may have had "premium" dental insurance with your previous employer, but that's gone now and would cost a lot to duplicate on your own.
It's not gone yet, actually. I agree replacing it may cost a lot, but since I won't be the one paying for the premium, "a lot" isn't a problem. Finding a policy with good benefits still seems to be a problem, though.
Macular degeneration (I know what it is) is not going to be helped much with vision insurance--it's a medical condition, and you'll already be seeing your ophthalmologist for that. The vision insurance may provide some discounts for glasses, but you can get glasses anywhere, from Costco or
online, for lower cost than the places that will accept the vision plan. (I used to be in the business.)
Well, it means my vision is declining, and I need new glasses frequently enough. My VSP coverage provides for 2 pairs of glasses a year. I did buy them at Costco already, as they accepted VSP, and in fact the policy had specific additional discounts for using Costco.
Why wouldn't you be the one paying the premium?
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

SuzBanyan wrote: Sat Jun 18, 2022 6:49 pm Both Aetna and United Healthcare appear to offer vision plans as add-on policies to individual dental coverage
Yes, I have seen that, but "add-on" won't work with the CA HIPP plan as the dental and vision will still be listed as two separate plans, and HIPP will only pay for the dental premium in this case, not for the vision premium.
Have you considered working with an agent?
Yes, but which agent ? An agent represents a specific insurance company. Very few insurance companies seem to offer combo dental/vision - so far, the only one I'm aware of is Surebridge - the one I mentioned in my OP. No one else has mentioned another insurance company that does.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

tj wrote: Sun Jun 19, 2022 10:54 pm Why wouldn't you be the one paying the premium?
Please read the OP. The state will pay for my coverage. But I need to find coverage. And it needs to be combo dental & vision plan.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

VTS3X wrote: Sat Jun 18, 2022 7:17 pm Worth checking what your medical insurance covers if your eye care provider takes your medical insurance.
My Kaiser Cal-COBRA medical plan will cover ophtalmologist and optometrist visits, only with Kaiser providers. It will not cover glasses or contacts anywhere, even at Kaiser. This is why I want a vision plan.
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celia
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Re: Need combo dental & vision plan in CA

Post by celia »

I’ve never heard of one plan that covers all 3 areas, although some Medicare Advantage plans may. You might try asking a Medicare counselor whose job is to hook you up with the best set of plans for you. They may or may not be willing to help you if you are under 65. Since Medicare pays the counselors a fee for each person they help, I don’t know if they are able to help you too. You can also call a SHIP counselor who provides the same information. They are located by going through your state’s Department of Insurance (or whatever your state calls it.)
https://www.shiphelp.org/about-medicare ... p-location


My other idea is to just keep the medical coverage you found and pay for glasses and dental work on your own, since the maximum benefits they pay are not really that much (say $1,200 max per year for dental as previously mentioned).

For vision, find an optical shop that will re-do your lenses for free if your prescription changes within a year. I’m pretty sure I’ve seen that. You can also re-use the frames, but they won’t be guaranteed after a certain point. In other words if you get 4 prescriptions in two years, here’s how your visits might go:
Visit 1: pay for new frames and lens. (Pay for both)
Visit 2: replace the lens only (free)
Visit 3: replace the lens only (pay)
Visit 4: replace the lens only (free)
Rinse and repeat but first figure out what you will do while the glasses are out for a week or so. Here’s where an alternate pair is needed.

The optometrist should know a cost-effective way to handle this since you aren’t the only person in this situation. So don’t be shy about asking around. There may even be a program that covers this besides regular insurance.


I also googled:
combined vision snd dental insurance
and saw several potential plans you could persue.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

celia wrote: Mon Jun 20, 2022 2:10 am I’ve never heard of one plan that covers all 3 areas, although some Medicare Advantage plans may.
I have not heard of a single plan that covers all 3 either. Fortunately, I don't need one that covers all 3. HIPP will pay for my premiums for separate medical & dental plans. And if the dental plan is a single combo plan that includes vision, it will still cover that plan - that's how I am trying to get vision covered.
You might try asking a Medicare counselor whose job is to hook you up with the best set of plans for you. They may or may not be willing to help you if you are under 65. Since Medicare pays the counselors a fee for each person they help, I don’t know if they are able to help you too. You can also call a SHIP counselor who provides the same information. They are located by going through your state’s Department of Insurance (or whatever your state calls it.)
https://www.shiphelp.org/about-medicare ... p-location
Thanks for the suggestion. I'm well under age 65, though, so this might not work. But I will look into it.
My other idea is to just keep the medical coverage you found and pay for glasses and dental work on your own, since the maximum benefits they pay are not really that much (say $1,200 max per year for dental as previously mentioned).
$1200 in maximum dental & vision benefits is still better than $0. Since the state will be paying the premiums, it doesn't make sense for me to forego dental/vision coverage.
For vision, find an optical shop that will re-do your lenses for free if your prescription changes within a year. I’m pretty sure I’ve seen that.
Would you mind telling me where you saw that ? I have not heard of this. One provider I know will redo the lenses if they scratch/break within a year, but not with a different prescription. This is because the lens manufacturer offers a warranty. AFAIK, Costco does not offer any kind of warranty on glasses/lenses, even for damage to redo the same prescription.
You can also re-use the frames, but they won’t be guaranteed after a certain point. In other words if you get 4 prescriptions in two years, here’s how your visits might go:
Visit 1: pay for new frames and lens. (Pay for both)
Visit 2: replace the lens only (free)
Visit 3: replace the lens only (pay)
Visit 4: replace the lens only (free)
Rinse and repeat but first figure out what you will do while the glasses are out for a week or so. Here’s where an alternate pair is needed.
Thanks. I believe I already have enough frames I can reuse to make this work, but the above assumes you can redo lenses with new prescription for free, which I know Costco won't. Also, Costco told me they charge a non-refundable $25 fee if you want to reuse existing frames. The fee goes towards testing them. If they determine the frames are too old/worn, they won't make the new lenses for them. The least expensive frames at Costco are usually around $50, so this may not save a lot of money vs getting new frames, but it can still make sense if the frames are in good shape, which some of mine are, but not all.
The optometrist should know a cost-effective way to handle this since you aren’t the only person in this situation. So don’t be shy about asking around. There may even be a program that covers this besides regular insurance.
I will certainly ask.
I also googled:
combined vision snd dental insurance
and saw several potential plans you could persue.
Google is the first place I went to look, but when I followed the links, none of the plans were actually combo dental/vision plans, but rather separate plans that could be sold together. The one and only plan I know about that is actually a combo is Surebridge, and I didn't find it through Google. I was told about it by the person processing my HIPP paperwork at Kaiser, because she has another patient in the same medical situation as mine that uses this plan :
https://www.surebridgeinsurance.com/ind ... insurance/

She wasn't aware of any other combo plan from anybody else. That is why I turned to Bogleheads to inquire. Maybe this isn't the right forum to ask, but I don't really know where else to turn.
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Re: Need combo dental & vision plan in CA

Post by tj »

Why not just get the best dental plan you can? Aren't there some with like 3k of benefits? Vision plans don't cover much.
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FreddieFIRE
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Re: Need combo dental & vision plan in CA

Post by FreddieFIRE »

tj wrote: Mon Jun 20, 2022 5:37 pm Why not just get the best dental plan you can? Aren't there some with like 3k of benefits?
Are you suggesting that those that pay the most are the "best plans?"
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tj
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Re: Need combo dental & vision plan in CA

Post by tj »

FreddieFIRE wrote: Mon Jun 20, 2022 5:53 pm
tj wrote: Mon Jun 20, 2022 5:37 pm Why not just get the best dental plan you can? Aren't there some with like 3k of benefits?
Are you suggesting that those that pay the most are the "best plans?"

Yes. A 3k plan is 3x better than a 1k plan, if the networks and reimbursement rates are the same.
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

tj wrote: Mon Jun 20, 2022 5:37 pm Why not just get the best dental plan you can? Aren't there some with like 3k of benefits? Vision plans don't cover much.
Do you know where I can find those sort of plans on the individual market ?
As vision is a regular expense for me, I would still like to have coverage, even if the plan doesn't cover a lot.
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FreddieFIRE
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Re: Need combo dental & vision plan in CA

Post by FreddieFIRE »

tj wrote: Mon Jun 20, 2022 6:11 pm
FreddieFIRE wrote: Mon Jun 20, 2022 5:53 pm
tj wrote: Mon Jun 20, 2022 5:37 pm Why not just get the best dental plan you can? Aren't there some with like 3k of benefits?
Are you suggesting that those that pay the most are the "best plans?"

Yes. A 3k plan is 3x better than a 1k plan, if the networks and reimbursement rates are the same.
What if the 3K plan costs three times more and you don't expect to max it out every year?
FIRE?? Just call me "Ready Freddie."
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

FreddieFIRE wrote: Mon Jun 20, 2022 6:43 pm What if the 3K plan costs three times more and you don't expect to max it out every year?
Three times zero is still zero.
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Re: Need combo dental & vision plan in CA

Post by FreddieFIRE »

madbrain wrote: Mon Jun 20, 2022 6:51 pm
FreddieFIRE wrote: Mon Jun 20, 2022 6:43 pm What if the 3K plan costs three times more and you don't expect to max it out every year?
Three times zero is still zero.
If your dental insurance costs zero, why are you asking for advice? :confused
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celia
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Re: Need combo dental & vision plan in CA

Post by celia »

Thrivent doesn’t have insurance for all three but those insured on their medical plans have discounts for vision and dental. However, I think you are limited to only certain dentists, which may be the ones with discount prices anyways. I may be wrong, but the participating dentists might be those who give everyone the discount rate. The participating dentist near us is one who is on a busy street with a line of patients hanging out the door. I’ve assumed the patients are in some kind of government program.

[Warning: We had Thrivent as our Medicare Supplement for a while. This plan offered a free discount drug plan that somehow overrode our Medicare Drug plan and our meds starting costing more. The CVS pharmacy computers could only process one drug plan and the Trivent drug plan, for an unknown reason, was giving me a discount of $0. Only Thrivent could ask that this benefit be removed (so our Medicare drug plan could pay).]

United HealthCare allows you to add a vision rider onto your dental insurance.


The “Best” dental plan is not the one that pays out the most, in my opinion. It has to pay out TO THE DENTIST OF MY CHOICE. I don’t care if my dental work is free if I have to go to an assembly-line discount dental office. I only want someone to work on me who I trust based on referrals from those I know.
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celia
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Re: Need combo dental & vision plan in CA

Post by celia »

FreddieFIRE wrote: Mon Jun 20, 2022 7:20 pm If your dental insurance costs zero, why are you asking for advice? :confused
OP is shopping for insurance now since current plan choices are ending. She/he will no longer have the current plans.

Re-read the original post for details.
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Re: Need combo dental & vision plan in CA

Post by FreddieFIRE »

celia wrote: Mon Jun 20, 2022 7:31 pm
FreddieFIRE wrote: Mon Jun 20, 2022 7:20 pm If your dental insurance costs zero, why are you asking for advice? :confused
OP is shopping for insurance now since current plan choices are ending. She/he will no longer have the current plans.

Re-read the original post for details.
Yeah, I got all that. I've been following right along. Re-read my posts for details. :P
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Re: Need combo dental & vision plan in CA

Post by DukeofDebt »

FreddieFIRE wrote: Mon Jun 20, 2022 7:20 pm
madbrain wrote: Mon Jun 20, 2022 6:51 pm
FreddieFIRE wrote: Mon Jun 20, 2022 6:43 pm What if the 3K plan costs three times more and you don't expect to max it out every year?
Three times zero is still zero.
If your dental insurance costs zero, why are you asking for advice? :confused
Yeah, that one lost me as well.
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Re: Need combo dental & vision plan in CA

Post by tj »

madbrain wrote: Mon Jun 20, 2022 6:34 pm
tj wrote: Mon Jun 20, 2022 5:37 pm Why not just get the best dental plan you can? Aren't there some with like 3k of benefits? Vision plans don't cover much.
Do you know where I can find those sort of plans on the individual market ?
As vision is a regular expense for me, I would still like to have coverage, even if the plan doesn't cover a lot.

I thought it was delta dental who offered such a plan, but I honestly don't remember.

I guess it wasn't delta dental, but In Arizona, delta dental offers dental+vision.


Edit, it was physicians mutual that does not have an annual benefit max

https://www.physiciansmutual.com/web/dental
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

FreddieFIRE wrote: Mon Jun 20, 2022 7:20 pm If your dental insurance costs zero, why are you asking for advice? :confused
A third party will be paying the premium. My share of it will be zero. I'm still looking for an insurer and plan.
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Re: Need combo dental & vision plan in CA

Post by SuzBanyan »

madbrain wrote: Mon Jun 20, 2022 9:03 pm
FreddieFIRE wrote: Mon Jun 20, 2022 7:20 pm If your dental insurance costs zero, why are you asking for advice? :confused
A third party will be paying the premium. My share of it will be zero. I'm still looking for an insurer and plan.
Is there a reason Surebridge won’t work for you?
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madbrain
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Re: Need combo dental & vision plan in CA

Post by madbrain »

SuzBanyan wrote: Mon Jun 20, 2022 9:10 pm Is there a reason Surebridge won’t work for you?
If I don't find anything else, it may work. My dentist is listed in their network, but only as accepting PPO. The search feature on their web site doesn't allow looking for "Maximum care" providers that are covered by the DVH plan. So there is still a question mark there. I would have to clarify that with the dentist & insurer.

No network issue for vision, however, they say you can go anywhere, so Costco should be OK.

The quote I did is just $92/month for the two of us at 46/50, and such a low premium makes me think that the benefits must be fairly limited. Indeed, the brochure indicates they only cover 60% for type II / type III dental services, and vision services for the first year. $100 deductible per person per year, also. There are not many scenarios under which it would be likely to pay more than the premiums in the first year. The max possible combined benefit is $2000/insured/year which is $333/month. If I had to pay the premium myself, I would be looking for better separate options.

CA is a big state. SureBridge is not a name I had heard of until recently when looking into this. I figured they can't be the only ones writing combo dental/vision plans. I am hoping someone else has those, with hopefully higher premiums/higher amounts of benefits.
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Re: Need combo dental & vision plan in CA

Post by madbrain »

DukeofDebt wrote: Mon Jun 20, 2022 7:39 pm Yeah, that one lost me as well.
I have edited the OP to make it clearer. Hopefully, it makes sense now.
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celia
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Re: Need combo dental & vision plan in CA

Post by celia »

OP, I have made a few local calls to help figure things out, but I am more lost than before I started. Over the weekend, I looked at VSP’s website for individual coverage (the patient pays monthly premiums) and saw they have 4 plans for individuals. The person I talked to represented California said none of those plans pays for more than 1 set of frames or 1 set of lens a year. Yet a local optometrist said VSP has a plan where you can get replacement lens up to 6 months after the original ones. So different employers or govt plans probably have different options when they choose a VSP plan for their employees. Of course, different states can have their own added restrictions/upgrades too.

I think some of the options are also lab specific, like the ability to re-use your frames. I fell and scratched up one lens a few years ago and my lab would only replace both. I asked for both old lens back (and my optical tech fought for this when they disappeared) with the idea if I scratched the lens on the other side, I should be able to use the 2 unscratched lens in the future. But the tech said that might not be possible. Even if you buy 2 identical sets of frames at the same time, the lenses from frames A may not fit correctly in frames B. :oops:

I called my local WalMart to learn that some stores are contracted with National Vision to run some of the Walmart shops and some optical shops are run by WalMart. National Vision (in WalMart) in CA doesn’t seem to do replacements, but I sort of expected that since their glasses are cheaper to begin with. But ours offers a $20 insurance warranty that lasts 6 months for loss?? or damage.

Target has some stores with optical shops, but today ours was clueless about everything. We ordered from them in the past and there are 2 or 3 factories were the glaases are made and then sent to the store.

I know Medicaid is different in each state. They cover glasses in Michigan once every 2 years but will replace or fix them for free if you bring all the broken parts in. (I had a disabled relative who would sleep with her glasses in bed so they wouldn’t be stolen in her group home. Once I figured this out, I had to convince her that no-one would want to wear her glasses just as she wouldn’t want to wear someone else’s glasses since they are customized for each person.) One of the CA optical shops I talked to today said our Medi-CAL has a different policy.

I’ve seen some vision plans with a discount plan for dental services and dental plans with a discount plan for vision. Maybe you can ask SureBridge who their competitors are. Also search their network of dentists and look for online reviews for those near you. Then call a dental office to ask if they are still part of the SureBridge/ Careington network. This SureBridge plan looks like it is just a plan of plans to me, with the underlying plans not being something I would sign up for (Careington, EyeMed, TruHearing). I would rather have one great dental plan or VSP for vision.


So my take-away is to ask each optical shop what lab they use and if their lab allows re-using frames. Also ask if they offer any warranties in case of damage.

Would it be an option to continue your cobra vision plan with you /HIPP paying the premiums? That’s what I did with LTC premiums when I retired 10 yrs ago and ended up with better coverage than what I would be able to find on my own.
Topic Author
madbrain
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Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Need combo dental & vision plan in CA

Post by madbrain »

celia wrote: Tue Jun 21, 2022 7:06 pm OP, I have made a few local calls to help figure things out, but I am more lost than before I started. Over the weekend, I looked at VSP’s website for individual coverage (the patient pays monthly premiums) and saw they have 4 plans for individuals. The person I talked to represented California said none of those plans pays for more than 1 set of frames or 1 set of lens a year. Yet a local optometrist said VSP has a plan where you can get replacement lens up to 6 months after the original ones. So different employers or govt plans probably have different options when they choose a VSP plan for their employees. Of course, different states can have their own added restrictions/upgrades too.
Thank you very much for checking this !
I think the employer-based plans indeed are very different from the plans available on the individual market.
My VSP plan allowed 2 pairs of glasses a year, without having to wait 6 months, BTW.
I know Medicaid is different in each state. They cover glasses in Michigan once every 2 years but will replace or fix them for free if you bring all the broken parts in. (I had a disabled relative who would sleep with her glasses in bed so they wouldn’t be stolen in her group home. Once I figured this out, I had to convince her that no-one would want to wear her glasses just as she wouldn’t want to wear someone else’s glasses since they are customized for each person.) One of the CA optical shops I talked to today said our Medi-CAL has a different policy.
I'm not on Medicaid/Medi-CAL, just to be clear. Our joint taxable income puts us above the threshold for that. We qualify for HIPP based on specific medical conditions, and projected income below a given threshold.
I would rather have one great dental plan or VSP for vision.
Yes, but HIPP will not pay for a standalone vision plan after federal COBRA expires, for some reason. I would have to pay for the premium plan on my own.
Would it be an option to continue your cobra vision plan with you /HIPP paying the premiums? That’s what I did with LTC premiums when I retired 10 yrs ago and ended up with better coverage than what I would be able to find on my own.
For dental / vision, there is no option to continue the existing plans, unfortunately. I have to shop for a plan after the 18 months of federal COBRA expire. This is the reason for my post here.
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