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Health Insurance for Eye & Dental Coverage

Vision and dental health are important factors contributing towards your overall physical well-being. Despite that, people neglect these factors when choosing health insurance policies. Health insurance plans might not come with eye and dental coverage together. That is why you must go through the inclusions of your health plan carefully to ensure comprehensive dental and eye coverage for you and your family, especially children. Usually, eye and dental care falls under the OPD cover, which means no hospitalisation cover is offered. In this blog, you will understand the importance of eye and dental coverage in health insurance.

Importance of Eye & Dental Coverage in Health Insurance

You must note that hospitalisation expenses regarding dental and vision impairment will be covered only if you have separate eye and dental coverage in your health insurance policy. Eye and dental care procedures can be expensive, which leads to unwanted financial strain in your pocket. 

Eye coverage in health insurance is ideal for individuals with previous medical problems related to their vision. Vision care insurance is not expensive and can be added easily to your primary health insurance plan.

Dental coverage can tailor the cost of your oral treatments and procedures. Oral coverage is best for children and senior citizens as these age groups face the most dental problems. Additionally, you can maintain oral hygiene by availing dental covers to avoid major dental issues in future. Below are the benefits of having eye and dental coverage in your health insurance plan.

  • Financial support
     
  • Preventive care
     
  • Coverage for consumables
  • Access to quality care
     
  • Cashless treatment
     
  • Peace of mind, etc. 

What are the Inclusions of Eye & Dental Coverage in Health Insurance?

As eye and dental coverage is not a standard cover, the inclusions vary based on the insurance company and their policy. Varied insurers levy a waiting period ranging between six months up to a few years. You must know that if you use the entire sum insured for this coverage, you will have to pay the extra amount. Below are some of the inclusions of the following coverage.

Coverage under Eye Insurance

  • Routine check-ups
     
  • Eye examinations
     
  • Corrective spectacle lenses with frame/contact lenses (as prescribed by the ophthalmologist)
     
  • Doctor consultations fees
     
  • Cataract surgery expenses
     
  • Lasik surgeries, etc. 

Coverage under Dental Insurance

  • X-rays
     
  • Oral check-up
     
  • Dental injury because of an accident
     
  • Root canal treatment
     
  • Fillings
     
  • Extractions
     
  • Preventive treatment, etc.

Note: The above-stated inclusions might vary based on the insurance company and their policy. 

What are the Exclusions of Eye & Dental Coverage in Health Insurance?

Like every other health care coverage, eye and dental insurance has the following exclusions. Note the exclusions might change as per the insurance company and the health plan you choose. 

Exclusions Under Eye Insurance

  • Injury caused by dangerous activities
     
  • Expenses due to wear and tear of consumables
     
  • Expenses for non-corrective lenses
     
  • Injury caused by oral hygiene procedures or cosmetic products, etc.

Exclusions Under Dental Insurance

  • Dentures
     
  • Jaw alignment
     
  • Implants
     
  • Prosthesis
     
  • Orthodontics, etc.

Why Choose ACKO for Health Insurance?

ACKO health insurance plans come in an extensive way to meet every insurance need of yours. With our comprehensive coverage, you can safeguard yourself and your family members from any unforeseen medical emergencies. A variety of all-inclusive health insurance policies catered to different needs are available from ACKO. 

The ACKO Standard Health Plan offers financial protection for medical expenditures via coverage with options for an amount insured ranging from Rs. 10 Lakhs to Rs. 1 Crore. It offers advantages including cashless claims, pre- and post-hospitalisation expenditure coverage, and critical illness coverage, to name a few. 

The ACKO Platinum Health Plan, on the other hand, provides quick and complete coverage without co-pay or deductions for approved claims. It includes increased benefits such as high sum insured, zero waiting periods, etc.

Furthermore, the Platinum Super Health Top-Up Plan goes beyond conventional limits in terms of coverage, offering sum insured options ranging from Rs. 10 lakhs to an unlimited amount, as well as coverage for critical illness expenses, helpful add-ons, multiple ambulance trips, and emergency evacuation. These features cater to people who want comprehensive protection against medical emergencies and expensive healthcare. 

Enhance your health insurance by exploring these unique benefits
OPD CoverCashless Health InsurnceRoom Rent LimitUnlimited Sum Insured  

The Bottom Line

Before buying a health insurance plan, you must look into a few important factors like the sum insured, waiting period, deductions on claims, inclusions and exclusions. In addition, you should consider family size as the bigger the family you have, the more comprehensive coverage you will need. You can get optimal health insurance coverage by exploring and comparing varied ACKO health plans. 

Frequently Asked Questions

Below are some of the commonly asked questions about eye and dental coverage in health insurance plans.

ACKO does not provide direct coverage for dental and eye-related treatments. However, if the treatment is medically necessary due to an unexpected event, then the claim may be accepted on a case-by-case basis.

Please visit our support centre at https://www.acko.com/contact-us/ for any assistance. We can guide you through the claim process in case you have the relevant coverage.

Root canal treatment is usually covered by dental insurance, but coverage can vary. It is advisable to consult your insurer to confirm specifics regarding your policy's coverage.

In India, you can claim tax deductions on health insurance premiums under Section 80D of the Income Tax Act 1961. In case you are below 60 years, you can get a deduction up to Rs. 25,000. Whereas, senior citizens (60 years and above) can claim up to Rs. 50,000 tax deduction on the premium amount paid towards their health insurance. 

Dental insurance policies may offer coverage for braces, but it varies depending on the specific policy. Some plans may cover a portion of the cost of braces, while others may not cover them at all. It is important to review your policy details with your insurer to understand what orthodontic treatments are covered.

To claim eye and dental coverage, typically you'd submit relevant receipts and documentation to your insurance provider. They will then process the claim based on the terms of your policy.

There is no specific "right" age to avail eye and dental coverage in health insurance. It is beneficial to have coverage from a young age to address preventive care and potential issues early on.

Disclaimer: The plans, services, features, processes, and other details mentioned on this page are subject to availability and changes. Please check the applicable policy wordings before making any insurance-related decisions. Feel free to reach out to us at [email protected] for any queries.

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Roocha Kanade profile avatar

Written by

Roocha Kanade

Content Architect

Dr Nitin Kumar Gupta profile avatar

Reviewed by

Dr Nitin Kumar Gupta

SVP – Health Underwriting & Claims at Acko General Insurance