Should I get dental/vision insurance? If so, which plan?

November 13, 2006 7:49 AM

Federal employee health benefit open season started today. I'm overwhelmed with the choices!

Can anyone help me sort this out? I'm in my twenties, in decent health, single. I live in zip code 33139. I consider myself to have weak teeth - I have good dental hygiene and don't eat much sweets, but I've had lots of caveties and a root canal. As for vision, I recently (almost 2 years ago) had to get glasses for the first time - 1 pair for night driving, 1 pair for computer work. And apparently the prescription is a bit wierd, so I can't just pick up glasses at CVS.

I'm trying to decide whether I should get dental/vision insurance and if so, which plans I should get. I've read the comparisons online (http://www.opm.gov/insure/dentalvision/dental.asp), and just really don't know what to do.

Any advice or even general wisdom would be appreciated.

posted by n'muakolo to health & fitness (3 comments total)

Do it. Get the plan with the lowest copays and highest coverages that you can afford. As someone who had no dental/vision insurance for years, you need consistent care to avoid expenses later on in life. I'm 26 years old, and after having been without dental insurance for two years, I needed a couple of minor procedures. (I had some gums wearing away that needed to be replaced to guarantee the health of the roots.) If I hadn't gotten insurance again a few months earlier, I would've been out thousands. Worring that I was going to need a procedure, while a minor stress, was always there in the background... and it's not worth it.

Now, which plan -- it depends on your personal finances. Can you handle a large out-of-pocket cost for a weekly pay savings? Keep in mind that benefits are pretax, so it's sometimes worth it to get better benefits because the actual dollar savings don't tell the full story in re: tax brackets, etc.

Now let's use an example. I'm using a round number just to illustrate.

2 crowns at $1000, intermediate procedure =
MetSTD: 55% = they pay $550, you're on the hook for $450
GEHA: $80% = they pay $800, you pay $200.
Your savings: $250.
Met is $8/biweek =208/yr, GEHA is $17 biweek = 442/yr Cost difference per year is $234. Not significant savings by having MetSTD... AS LONG AS you don't need to put the $450 on a credit card or otherwise finance it. Then you're much better off with GEHA.

Since you've had root canals and might need another, make sure you watch the high % as well. I don't know what they run to know if you'll have any savings. Pull your records from your last procedure. ;) Keep an eye on your yearly limits, too. The above crowns wiped out half of GEHA-high's yearly limit for almost two years. With that in mind, if you do need significant care, MetLife High is a bargain at $14.50/biweek.

Is it worth it to you to pay more pre-tax, knowing you won't have a big out of pocket cost if you do need a procedure? Or is it worth it for you to self-insure to an extent and put the extra money into a savings account post-tax (or even a pre-tax health savings account if your employer offers it) against the chance that you might need a procedure, but if you don't, you can roll it over to the next year?
posted by SpecialK at 8:17 AM on November 13, 2006

Oh, and on the pre-tax/post-tax thing ... I remember being shocked when I maxxed out my 401(k) contribution while at an employer a few years ago. I was shocked when my take-home pay went UP -- it turns out that I put myself into a very low tax withholding bracket by maxing out my 401k. Best thing I ever did.
posted by SpecialK at 8:19 AM on November 13, 2006

The Washington Post Federal Page always has info on federal worker's benefit plans. Today's article mentioned that employees who don't expect high dental bills might want to use the FSA plan instead of the dental/vision.

This way, you'd still get the tax savings, but you'd have more flexibility about how your money is spent.

Also, they started a new site today to compare dental/vision plans at benefeds.com.
posted by saffry at 8:44 AM on November 13, 2006