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Self-employed guide to individual dental and vision insurance

How dental and vision insurance can help protect self-employed workers from unexpected costs.

Self employed or independent contractor is becoming an increasingly frequent job title in today’s economy.1 According to a 2018 survey of 6,000 U.S. workers by Upwork and the Freelancer’s Union, there are 56.7 million freelancers in the United States, and they represent one in three workers in the country.2

People who fall in this category may prefer a variety of titles such as independent worker, independent contractor, consultant, self-employed, freelancer, temp, or on-call employee, but they share many of the same traits. For instance, they value the flexibility and freedom that comes with this kind of alternative work arrangement. No one company or client is typically their main source of income, so they may work for several companies.3

Why self-employed workers demand dental and vision insurance

Independent workers are also becoming increasingly more satisfied with their choice to work independently over time. “Some 76 percent of full-time independents said they were very satisfied with their choices and path, up from 72 percent in 2018, and up sharply from 63 percent in 2015,” according to the 2019 MBO Partners State of Independence in America Report.4

However, like any type of job, there are typically trade-offs, and independent workers are no exception to this. Many contractors receive few benefits from those that employ them, or none at all, so they have to factor the cost of those benefits, such as the cost of insurance, into their regular income.

Independent contractors may work well over the typical 40-hour workweek and have concerns about unstable earnings. Concerns about pay or clients failing to pay for services rendered are additional stressors this type of worker deals with more often than those working for just one employer as a full-time employee.

Many independent workers are uninsured because they may not know where to start or have trouble justifying the cost of insurance. According to a Forbes article from 2018, 28% of freelancers buy their own healthcare plan and 50% have seen their premiums rise significantly.5 Independent workers have a lot to consider when it comes to their expenses, and insurance as an immediate need may not always be prioritized.

Making dental and vision insurance a priority can help independent workers prevent larger health problems later. With preventive care coverage, independence in where and when contractors can work becomes even more possible.

Reasons independent workers need dental and vision insurance 

There are many ways that insurance can help independent workers. As an example, people purchase this type of insurance to receive care for specialized needs not traditionally covered under their general health insurance. A doctor may be able to examine a chipped tooth, as an example, but cannot do the necessary repairs to restore the tooth. 


Story: Ellie the accountant*

Consider the case of Ellie, an independent contractor who works as an accountant for several companies in her city. She has purchased healthcare coverage for her general needs and takes advantage of annual physical exams with an in-network doctor. 

However, when Ellie chipped a tooth during a dinner out with family, her doctor was unable to help her and referred her to a dentist. Dental insurance could have saved Ellie from paying $450 out of pocket for a dentist repairing her chipped tooth. The money she had saved up for a new computer that could have helped her career instead had to go towards paying for the chipped tooth. 

Now that Ellie has learned about dental insurance and enrolled in coverage, she can stress less in case the unexpected—like a chipped tooth—happens again.


If you are self-employed, work as a freelancer, or participate in the gig economy, insurance may not be something you prioritize. However, ongoing expenses such as medication or regular doctor’s appointments could impact the amount of money you have available for other needs. Dental and vision insurance can help with these regular expenses so you can use the money you earn for other things, like reinvesting in your business.

As a self-employed individual, you might rely on infrequent income streams, so you have to be smart about your budget. Dental and vision insurance can be an asset because it provides you with a way to have healthcare expenses on a set schedule versus unexpected, surprise payments. The stability of paying for insurance and related costs can help you avoid surprises no matter what your income looks like at any given time.

Additionally, dental and vision insurance can act as a cushion when something unexpected happens. If you are self-employed, it is likely difficult, if not impossible, to find someone to fill in for you when you can’t work. Your health is even more important when you work for yourself than it might have been if you worked full-time for someone else. 


Story: Carl the IT professional*

When Carl decided to become an IT consultant after a successful career in IT, one of the first things he prioritized was getting insurance to cover the cost of his eye exams. Carl has a family history of glaucoma, and it was important to Carl to regularly see his eye doctor to make sure his vision was in good health.

Supplemental vision insurance gives Carl the financial security he needs to focus on providing for his clients while also making sure his healthcare doesn’t take a back seat.


You can’t always plan for when you have to take time off of work to take care of your health, but having insurance before the unexpected occurs can make the situation easier.

Types of individual dental insurance

Dental insurance is one of the most common types of insurance purchased alongside traditional health insurance coverage, with 7.1% of Americans purchasing individual coverage.6

Dental insurance covers a portion of the cost of a range of dental services from routine preventive care to dental surgery.

Dental insurance can be useful to have when you need to cover costs related to dental procedures.

DHMO vs. DPPO

Dental insurance plans are broken out into two categories: Dental Health Maintenance Organization (DHMO) plans, and Dental Preferred Provider Organization (DPPO) plans.

Each type has certain benefits and disadvantages, so it’s important to understand how both work before you enroll into either category of plan.

DHMO plans allow for discounted coverage for enrollees visiting healthcare providers in their network. These providers have agreed to accept payment at a discount for any services they provide to people with a DHMO plan. 

Depending on your needs and goals, a DHMO plan may be beneficial for you since it has the following advantages:

  • Lower costs – Providers who are part of a DHMO are often cheaper or even provide care for free for some services when someone within their network sees them. This can be an asset to contractors paying their monthly premium and who are in good health but looking for annual checkups and other similar services.
  • Zero co-pays for preventive care – While patients are responsible for a small office visit fee and co-pays for each procedure, most preventive care under a DHMO is zero.
  • Easier claim filing – With some types of coverage, patients may have to file claim forms with insurance companies. Not so for DHMO plans! Providers typically file claim forms on behalf of patients. When you’re a contractor, this can help a lot because you can rest assured knowing the provider will file your claim instead of having to keep track of if yourself.
  • No annual maximum for services – Some DHMO plans have no maximum amount of services for which you can be covered, which can certainly save time and money if an accident happens.

DHMOs do come with some disadvantages you will need to weigh when thinking about plan types. For instance, DHMOs have coverage limitations. As an example, the number of dental providers you can see in network may be smaller, so you may be restricted to a shorter list than if you had a different plan. There is also a copay to consider, which can still be significant for some procedures like root canals or crowns.

PPO plans, on the other hand, have a larger network of dentists with negotiated rates. You can save up to 35% of stand charges. You can also go outside of your network if you like.

If you enroll in a DPPO plan, you may take advantage of the following benefits:

  • Not limited to in-network care – Almost any provider will see patients with DPPO plans and insurance will cover part of their services. Plus, there is no paperwork for you to submit if you use an in-network DPPO dentist. 
  • No referrals needed – No need to have a set primary care provider. With a DPPO plan, you can see other providers without referrals, which can help a lot when deciding on the type of care you need.
  • No co-pays – Your policy under a DPPO plan is less likely to have a copay at your appointment, so all you need to do is sign in and wait to be seen - no hassles! The insurance covers a percentage of the doctor’s fees and there will be a portion you must pay later, but that is the tradeoff of enrolling in a DPPO versus a DHMO.

Some of the disadvantages of DPPO plans include that co-pays work differently than with DHMOs and coverage is different for the percentage of doctor’s fees the insurance covers. There is also usually an annual maximum cap on coverage for services and procedures.

Every person in the independent workforce has different needs and goals with their healthcare, so choosing a policy that fits what you need may be different than what your colleagues need. Talk to the insurance companies you are considering to find out what their supplemental insurance policies cover so you can make an informed decision.

What is supplemental insurance?

Supplemental insurance, by definition, is additional insurance that can help with out-of-pocket costs and services outside of what your healthcare insurance typically covers. For instance, your typical healthcare coverage may include seeing a general practitioner for a physical, but it is unlikely to cover prescription lenses or visiting a dentist to have a dental crown fitted. We primarily discuss dental insurance and vision insurance throughout this guide, although other types will also be covered.

Accidents and their ensuing injuries are also a cause of stress for individuals in the independent workforce. Injuries in your day-to-day life are less stressful when you know you have supplemental insurance to fall back on if you end up in the worst-case scenario and are unable to work.

Along with peace of mind, dental, vision and supplemental insurance is often easy to access anytime, day or night. Enrolling and submitting claims online is easy to do no matter the time of day. This is a boon for independent contractors who set their own hours and may need to talk to someone at their insurance company long after typical business hours end. Plus, most companies offering supplemental insurance are trusted sources and have robust security to keep your health information safe, with nationwide coverage available all year round.

Most businesses do not have health insurance coverage for contractors since contractors are not considered employees.7 Rather, most independent workers have several clients but still lack the benefits traditional employment might provide. Enrolling in insurance like dental insurance, vision insurance, or supplemental insurance helps contractors provide their own coverage, giving them the freedom to choose the level of coverage they want.

How much does insurance cost?

The cost of insurance varies. You can expect to pay monthly, quarterly, or annually to cover one half of the year upfront and the other half at a later date. Every plan is different, so it is important to talk to your insurance company and ask these questions when enrolling. 

Also, the cost of insurance depends on how many people you plan to cover, such as yourself or additional family members, and what the coverage looks like for that specific plan type.

Ways to save money on health insurance

Independent contractors can save a lot of money if they rely on supplemental insurance to cover their health needs. You may only have to pay deductibles and copays for coverage, in some cases, versus tapping into your savings.

For many contractors, savings is at a premium and costs can add up. In addition to covering healthcare costs, contractors typically try to have an emergency savings built up for worst-case scenarios such as appliance failures at home or sudden vehicle repairs. Anything that can reduce the need to use savings is helpful.

Additional ways that contractors can save money on healthcare costs include:

  • Enrolling in a Health Savings Account (HSA) – An HSA is an excellent way to set aside funds for healthcare needs. Many HSAs roll coverage over to future years, but some are only annual, so funds set aside in an HSA can help cover costs like prescriptions or surgeries when the time comes to have them. Plus, money contributed to an HSA is pre-tax, meaning contributing to it reduces your taxable wages.
  • Keep Visits In-Network – For some insurance policies, going to a provider out of network can be more expensive. If your policy favors visits to in-network providers, schedule appointments with them as often as possible to pay as little as you can on your healthcare.
  • Use Preventive Care Wisely – Don’t skip scheduled appointments and make it a regular part of your care to contact your provider about ways to prevent issues. If you do what you can to prevent small health problems today, you’ll see that they don’t become larger issues later.
  • Make Steps Toward Healthier Living – Take the time to build small habits that help your health overall. If your work is relatively sedentary, take regular breaks to move around or join a walking club to stay active. You’ll quickly see how incremental changes can help your health overall in the future and reduce your healthcare costs down the road.

As an independent contractor, you don’t have time to waste on coverage that doesn’t fit what you need. For most contractors, time really is money, so a policy that is flexible, gives you the ability to contact someone at any time of the day with questions, and that keeps your information secure can be  of the utmost importance. Companies like Guardian Life Insurance Company of American understand what you’re looking for and provide options that fit your lifestyle through Guardian Direct.

What’s covered under supplemental insurance?

Supplemental insurance is insurance that compliments but does not replace your major medical insurance to help with expenses your medical insurance may not fully cover. For example, accident insurance helps with expenses such as deductibles, co-pays and coinsurance so you don’t have to use savings to cover the expenses of an unexpected accident. Supplemental insurance may be helpful if your medical insurance plan has a high deductible, which is common in high-deductible health plans.

What Guardian Direct® dental insurance covers

Dental insurance can cover basic services such as dental exams and cleanings. Other types of services that are covered can include dental fillings and root canals. What is covered depends on the type of plan you get.

Guardian Direct DHMO plans, for instance, have no maximum dollar payout for each benefit year and your Plan Summary details what your plan covers.

By contrast, Guardian Direct’s DPPO plans cover a percentage of dentist's charges by category of service, with the categories being preventive, basic, or major. The plan color designates the percentage Guardian covers, with gold plans having higher coverage, silver plans a medium level of coverage, and bronze a lower level of coverage.

What Guardian Direct® vision insurance covers

Vision insurance with Guardian Direct Focused Vision plans, powered by VSP®, have no deductibles (amounts that you must cover before the plan pays benefits) and no waiting periods. There are different levels of coverage with different plan allowances, for instance, the Gold plan has a higher plan allowance for glasses and contacts than the Silver plan. Whichever plan you choose, you’ll always get the most out of your plan when you see an in-network doctor.

  • Exams – Included with a $15 copay from a VSP network doctor
  • Glasses and frames – With the Silver plan, you’ll get a $160 frame allowance, and with the Gold plan, you’ll get a $225 frame allowance. In addition, you can save 20% on any amount over your frame allowance. Plus, get an extra $20 to spend on featured frame brands.** If you to purchase a second pair, you’ll receive 20% savings on additional eyeglasses and sunglasses, including lens enhancements, from any VSP network doctor within 12 months of your last WellVision Exam®.
  • Lenses – Single vision, lined bifocal, and lined trifocal lenses are included with prescription glasses and covered after a $25 copay. Also, you can save 20-25% on lens enhancements.
  • Contacts – Looking for contacts instead of glasses? Guardian Direct covers them in full up to your plan allowance. Plus, you can save 15% on the contact fitting when you enroll in this plan.
  • Online eyewear store – Find more eyewear and use your VSP vision benefits at eyeconic.com.
  • Laser vision correction savings – Save 15% on average off the regular price or 5% off the promotional price for laser vision correction surgery from contracted facilities.
  • Digital hearing aids – In select states, those who are enrolled in vision insurance can receive discounts on digital hearing aids through TruHearing®*** at truhearing.com

Even if you are in good health, investing in vision insurance can help with preventative issues and the unexpected, such as if your vision deteriorates over time.


Story: Mark the copywriter*

Mark was new to independent contract work and decided not to enroll in vision insurance. He figured he would be fine without it. However, over time, Mark realized his long hours in front of a computer writing for clients led to vision problems, and for the first time in his life he needed glasses to be able to see.

Although Mark found a good eye doctor with fair pricing, paying out of pocket for an exam and glasses drained his savings. Mark would have saved a lot of time and stress if he had signed up for insurance when he had the chance, avoiding cash flow issues that set him back several hundred dollars.


Every insurance policy has different terms, and what’s covered can vary. The best way to know what you have available to you is to read the policy when you start to enroll. If your current insurance is missing coverage you’d like to explore, then don’t be afraid to shop around! 

Special considerations as you approach retirement

Traditional Medicare does not include any dental8 or vision9 coverage. If you are already enrolled in individual dental and vision insurance when you retire, you can continue to use these products in retirement to supplement Medicare. Since you won’t have to switch your dental and vision coverage in retirement, you can keep your current dentist and eye doctor, making the transition to retirement that much easier.

What plan features to consider when selecting a plan

When considering supplemental insurance, you should think about what different plan types cover. Not all dental or vision plans have the same coverage, so it is important to understand the differences and ask questions if you do not.

For instance, VSP teamed up with Guardian to bring vision benefits designed just for you, with no deductibles and no waiting periods. This means that when your coverage starts you can not only see a provider right away, but you don’t have to cover any amounts before the plan pays benefits.

It is important to read your policy to make sure you understand if you are covered right away for some of the services you want to use, like exams.

When you are looking at policies and deciding on your dental or vision insurance plan, some things to consider include:

  • Freedom to choose your own provider – How important is it to you to choose which provider you see? If you have no preference and don’t mind working from a select list, DHMO plans may be for you. However, if you would rather have more freedom choosing which providers you see, a DPPO plan may be a better fit.
  • What it covers – Dental procedures at most dental insurance companies are grouped into three main categories: preventive, such as cleanings, exams, and x-rays, basic, such as fillings and simple extractions; and major dental work, such as root canals, crowns, implants, and kids’ braces. Many plans cover preventive care at 100%, basic procedures at 50-70%, and major services, such as surgery, at 50%. However, coverage and costs can vary depending upon the plan level you select. Many plans have caps on what they will pay during a plan year, which can increase the longer you have the plan.
  • Plan limits – Understanding the plan limits can help you determine which supplemental insurance policy is right for you. DHMOs, as an example, have a limited number of providers you can visit.
  • Dental network – If you have an appointment with an out-of-network provider that is not part of the DHMO, you will pay more and not be covered by the plan for the cost of their services.
  • Referrals to specialists – Some insurance plans require referrals to see a specialist while other plans let you see a specialist without one. Depending on your healthcare needs, it may not be a problem for you to wait on a referral for a specialist. However, if you anticipate seeing specialists often, a plan that does not require referrals may save you the time and hassle of waiting to be seen sooner.

Other types of insurance to consider

In addition to dental and vision insurance, some other types of supplemental insurance that independent contractors may benefit from enrolling in include accident insurance, critical illness insurance, pet insurance, disability insurance, life insurance, travel insurance, and phone and device insurance.

Having accident insurance may help you if you suddenly become disabled and are unable to work for a period of time.

Critical illness insurance protects you if you are diagnosed with one of several predetermined illnesses in the policy, such as cancer, stroke, or heart attack. Policyholders typically receive a lump sum payment in the case of critical illness under these policies. Plan benefit for pre-existing conditions is limited to occurrences at least 12 months following the coverage start date. View a full plan summary for more details.

As an independent worker, you understand that you take risks every day. However, you likely are not willing to risk your family’s future. Life insurance is an essential investment into their future because it provides them assistance in the event of your death. You can still provide for them long after you have passed away when you enroll in life insurance.

If your work requires travel, or you happen to enjoy traveling as a benefit of being independently employed, travel insurance may be of benefit to you because it gives you extra healthcare protection when you travel abroad.

If you’re in the independent workforce, your devices may be an important part of your work. Insurance in case your laptop, tablet, or phone get lost or broken can help you stay in touch with your clients and avoid any delays in getting work done.

Why Guardian Direct dental and vision insurance is a good fit for the self-employed

Independent contractors choose Guardian Direct Dental and Vision for supplemental insurance because it is fast, secure, and affordable, all things that contractors value. With coverage nationwide and all year, Guardian Direct provides self-employed contractors with peace of mind when it matters most.

Fast coverage

Enrollment in either Guardian Direct dental insurance or vision insurance is fast. You can go from quoting to enrolling in a matter of minutes, so you can be covered sooner than you think!

Secure coverage

Your healthcare is a serious business, and partnering with a provider that understands the importance of security is vital. Payment information on the Guardian Direct website is secure anytime you need to access your profile. The peace of mind security provides can make the lives of independent contractors easier because they can stress less about who has access to their information.

Affordable coverage

The finances of an independent contractor can be unpredictable, but your insurance premiums should be stable and reliable. Guardian Direct has affordable coverage, with regular payment options that work well for contractors.

Nationwide coverage

Worried you won’t have coverage where you are? Worry no longer. Guardian Direct offers coverage in most states, meaning you can be located throughout the U.S. and be covered. For contractors, this can be important if they like to travel and work on the go or want coverage while on vacation away from their usual provider.

Enroll at any time

You can enroll any time of year, not just within certain enrollment periods like other plans. We work hard to make sure you are covered when you’re ready and can focus on what’s important to you: working for your clients with the freedom and flexibility that comes with being in the independent workforce.

 


Insurance glossary

There are many terms to learn when exploring the healthcare insurance marketplace, especially if you have to compare plans across insurance companies. We cover terms like premiums, deductibles, in network, and out of network in detail below, but each section throughout this guide provides concrete ways in which these terms can be applied in real-life situations.

Premiums  A premium is the amount of money paid for an insurance policy. A premium is typically a monthly cost associated with having the coverage for health insurance, but it may also be a semiannual cost paid twice a year just like any other type of insurance such as car insurance. In other words, you may have the option to pay it monthly, quarterly, or annually. 

Co-pays A copay is a fixed cost associated with healthcare service and is typically paid at the time of an appointment. For instance, if you have a copay for an eye exam, you pay the copay when you sign in for your appointment at the office. The remaining balance following your appointment is typically covered by the insurance provider.

Depending on if a service is seen as routine or not, the co-payment can vary within a plan. For example, you may have a $25 copay to see a doctor, a $75 copay to see a specialist, and a $10 copay for generic drugs. It is important to read your policy to better understand what your co-pays may look like for essential, regular services versus those that are not considered a typical service.

Deductibles –A deductible is a fixed amount paid by the insured person before the insurance company begins paying for services. Depending on your needs, a higher deductible may be more useful if you are the kind of person who doesn’t typically have a significant need for regular care.

However, if you find yourself needing to visit a doctor more often, a lower deductible plan may be right for you since the insurance company begins paying for coverage sooner with that kind of plan.

In-network Insurance works best when partnering with an in-network provider, meaning a doctor or dentist that accepts that kind of insurance. When a provider is in network, you no longer have to worry about submitting claim forms to the insurance company, as an in-network provider submits claim forms directly to the insurer on your behalf. For independent workers, that can be a huge benefit and time saver.

Out of network An out-of-network provider is a provider that is not part of the network of providers an insurance company partners with, so services with that provider may be more costly than with an in-network provider. Some services may be better suited to working with a provider that is out of your typical network. For instance, you may find an excellent provider with a specialty to help you with a condition, but they are not in network. That doesn’t mean you are unable to see that provider, but the cost may be higher.

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Sources:

1. https://www.irs.gov/pub/irs-soi/19rpindcontractorinus.pdf (Last accessed January 2020)
2. https://www.upwork.com/i/freelancing-in-america/2018/ (Last accessed January 2020)
3. https://www.upwork.com/i/freelancing-in-america/2019/ (Last accessed January 2020)
4. https://s29814.pcdn.co/wp-content/uploads/2019/06/MBO-SOI-2019.pdf (Last accessed January 2020)
5. https://www.forbes.com/sites/elainepofeldt/2018/10/31/freelancing-economy-continues-to-roar/#522040be7df4 (Last accessed January 2020)
6. https://www.nadp.org/Dental_Benefits_Basics/Dental_BB_1.aspx (Last accessed January 2020)
7. https://www.acf.hhs.gov/css/resource/the-difference-between-an-independent-contractor-and-an-employee (Last accessed January 2020)
8. https://www.medicare.gov/coverage/dental-services (Last accessed January 2020)
9. https://www.medicare.gov/coverage/eye-exams-routine (Last accessed January 2020)

 

* “All names and occupations mentioned herein are purely fictional and have been created solely for example purposes. Any resemblance to existing situations, persons or fictional characters is coincidental.”

**Brands/Promotion subject to change. 

***VSP is providing information to its members, but does not offer or provide any discount hearing program. The relationship between VSP and TruHearing is that of independent contractors. VSP makes no endorsement, representations or warranties regarding any products or services offered by TruHearing, a third-party vendor. The vendor is solely responsible for the products or services offered by them. If you have any questions regarding the services offered here, you should contact the vendor directly. TruHearing offers individuals the opportunity to purchase hearing aids at discounted prices, including individuals covered by self-funded health plans not subject to state insurance or health plan regulations. TruHearing is not insurance and not subject to state insurance regulations. TruHearing provides discounts to certain health care groups for hearing aid sales and services; TruHearing provides fitting, programming and three adjustment visits at no cost; the member is obligated to pay for testing, and all post-fitting hearing care services, but will receive a discount from those health care providers who have contracted with TruHearing. Not available directly from VSP in the states of Washington and California.

Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation. 

Dental

Individual dental insurance products are underwritten by The Guardian Life Insurance Company of America, New York, New York or by one of its wholly owned subsidiaries. Products are not available in all states. Policy limitations and exclusions apply. The actual limitations and exclusions that apply to your Dental Plan are governed by the policy forms approved for use in your state. Please refer to your policy for a complete list of limitations and exclusions. In the event of a conflict between this document and the language stated in your Guardian insurance policy, the language of the policy shall control. This policy provides DENTAL insurance only.

Dental provider networks vary by state, by market and by plan type

Rates are guaranteed for one year for your policy of benefits initially selected. Policies renew annually.

IMPORTANT INFORMATION ABOUT GUARDIAN’S DENTALGUARD INDEMNITY AND DENTALGUARD PREFERRED PPO PLANS

Dental PPO plans provide in-network and out-of-network benefits. Use of an in-network provider may result in reduce out of pocket costs.

Coverage is limited to those charges that are necessary to prevent, diagnose or treat dental disease, defect, or injury. Deductibles apply. Waiting periods may also apply for some services

Individual dental plans do not pay for: oral hygiene services (except as covered under preventive services), orthodontia (unless expressly provided for), cosmetic or experimental treatments, any treatment to the extent benefits are payable by any other payor or for which no charge is made, prosthetic devices unless certain conditions are met, and services ancillary to surgical treatment.

Individual dental plans limit benefits for diagnostic consultations and for preventive, restorative, endodontic, periodontic and prosthodontic services.

Listed services, exclusions and limitations do not constitute a contract and are a summary only.

IMPORTANT INFORMATION REGARDING DENTAL HMO BENEFITS

Dental HMOs provide Pre-Paid dental benefits through a network of participating general dentists and specialty care dentists. All covered services must be provided by the member’s Primary Care Dentist. Specialty care services are covered only when referred by the member’s Primary Care Dentist and approved in advance by the Dental DHMO.

Only those services listed in the Dental HMO plan are covered. Certain services are subject to annual or other periodic limitations. Where orthodontic benefits are specifically included, your policy provides for one course of comprehensive treatment per lifetime, per member. Dental HMOs do not provide orthodontic benefits if comprehensive orthodontic treatment or retention is in progress as of the member’s effective date. Listed services, exclusions and limitations do not constitute a contract and are a summary only.

Products Underwritten by Guardian Life Insurance Company of America

DENTAL PPO PLANS  Policy Form IP-DEN-16 ET. AL.

DENTAL HMO PLANS

      FLORIDA              Policy Form IP-1-MDG-DHMO-FL-OFF-17

      NEW YORK          Policy Form IP-MDG-NY-FP-OFF-17

 

Products Underwritten by Managed Dental Guard, Inc.

DENTAL HMO PLANS

      TEXAS                 Policy: IP-1-MDG-DHMO-TX-17

 

Products Underwritten by First Commonwealth Inc. through its Illinois subsidiaries*

DENTAL HMO PLANS

      ILLINOIS             Policy: IP-FCW-DHMO-IL-17

*First Commonwealth Insurance Company — (IL), First Commonwealth Limited Health Services Corporation — (IL), First Commonwealth of Illinois, Inc.

 

Information on the approved state and product specific online enrollment form numbers can be viewed here: Online Enrollment Form Numbers

 

Vision

Products are not available in all states. Coverage terms and conditions are set forth in the policy under which the individual consumer is insured, and such terms and conditions vary according to the laws of the state in which the policy was issued.  Policy limitations and exclusions apply. Please refer to your plan documents for a complete list of limitations and exclusions. Plan documents are the final arbiter of coverage. This policy provides VISION insurance only.

Vision insurance is provided by VSP.  Billing and premium collection services for VSP vision insurance is provided by DTC GLIC, LLC., a wholly owned subsidiary of The Guardian Life Insurance Company of America ("Guardian").  Guardian and DTC GLIC, LLC are not affiliated with VSP.  Guardian and DTC GLIC, LLC do not assume any responsibility or liability for non-Guardian products or services, including those offered by VSP.

VSP and WellVision Exam are registered trademarks of Vision Service Plan. TruHearing is a registered trademark of TruHearing, Inc. All other brands and marks are the property of their respective owners.

 

TruHearing®

TruHearing’s digital hearing aid discount plan is available to VSP members and is not insurance. TruHearing is an independent third party not affiliated with Guardian. The discounts for hearing aids are available only from participating TruHearing providers and will vary depending on the provider or service received. TruHearing does not make payments to providers for the services received under the discount plan. You are obligated to pay for all medical or ancillary services but will receive a discount from those TruHearing providers that have contracted with Truhearing. VSP does not provide or operate any discount hearing program. The relationship between VSP and TruHearing is that of independent contractors. VSP makes no endorsement, representations or warranties regarding any products or services offered by TruHearing, a third-party vendor. The vendor is solely responsible for the products or services offered by them. Not available in WA, UT, MD or CA. To obtain additional information go to TruHearing.com or call 1-844-571-9952.

VSP is providing information to its members but does not offer or provide any discount hearing program. The relationship between VSP and TruHearing is that of independent contractors. VSP makes no endorsement, representations or warranties regarding any products or services offered by TruHearing, a third-party vendor. The vendor is solely responsible for the products or services offered by them. If you have any questions regarding the services offered here, you should contact the vendor directly.

TruHearing offers individuals the opportunity to purchase hearing aids at discounted prices, including individuals covered by self-funded health plans not subject to state insurance or health plan regulations. TruHearing is not insurance and not subject to state insurance regulations. TruHearing provides discounts to certain health care groups for hearing aid sales and services; TruHearing provides fitting, programming and three adjustment visits at no cost; the member is obligated to pay for testing, and all post-fitting hearing care services, but will receive a discount from those health care providers who have contracted with TruHearing. Not available directly from VSP in WA, UT, MD or CA.

 

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.
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