Skip to main content

Are Dental and Optical Add-Ons Worth It? Twenty-One Is the Dividing Line

• Amy Tao

“I wear glasses, and dental work here is so expensive — should I get dental and optical cover?”

The answer depends on age: for adults over 21 I do not usually recommend it. For children and teenagers under 21 I strongly recommend it. It is the same reason in both cases. This is an everyday allowance benefit with modest reimbursement limits, so whether it is worth it comes down to the premium and how often you actually use it.

What it actually is

Dental and optical cover is not a standalone policy. It is an add-on bought on top of health insurance, and its nature is an everyday care allowance. Beyond dental it typically includes glasses, acupuncture, osteopathy and hearing, each with its own annual limit.

Taking nib’s dental and optical options as an example, the annual limits run roughly like this: dental examinations, cleaning, fillings and extractions combined $500; orthodontics $500 after two years of continuous cover; optometry and dispensing consultations $275; glasses or contact lenses $330; acupuncture $250; chiropractic and osteopathic treatment $250 each. (Your own policy’s current wording is what governs.)

Over 21: the leverage is too low

An adult’s add-on premium might run seven or eight hundred dollars a year. Against that, dental reimburses at most $500 to $750 a year and glasses a few hundred. You would need to visit the dentist every year and replace your glasses every year to roughly break even. If you do not go often, keep a pair of glasses for several years, and have not had acupuncture or osteopathy in living memory, it does not add up.

The leverage on health insurance is tens of dollars of premium against tens of thousands of dollars of surgery. The leverage on this add-on is hundreds of dollars of premium against hundreds of dollars of reimbursement. Those are not the same product.

For anyone under 21, insurers price the premium at child rates, which makes the add-on cheap — around $9 a month at the low end. For a child losing baby teeth, a teenager who needs braces, or a student who wears glasses, a single dental visit or one pair of glasses covers the premium, and there are several other categories to claim against.

A common misunderstanding: wisdom teeth do not need this add-on

People often assume removing wisdom teeth depends on dental cover. It does not — wisdom tooth extraction is covered by health insurance itself, because in New Zealand it counts as minor surgery, sometimes under general anaesthetic, and it is not cheap. The conditions are that removal is recommended by a dentist or doctor and your policy has no relevant exclusion, plus two things to watch:

  1. Wordings differ by insurer; some require a year in force first.
  2. Insurers usually require the work to be done by an oral surgeon, not a dentist at a general practice.

So talk to your adviser before the extraction, and get prior approval if you can.

One more thing

Not every insurer offers a dental and optical add-on, and the requirements and wordings differ. If you want to know which works best for your family, send me your situation and I will compare them.

While you are looking at what to cut, it is worth reading the other benefits already sitting in your policy — some of them return more than this add-on ever will.

Want the dental and optical add-ons compared? Get in touch with Cornerstone Insurance.

Phone: +64 211 280 727 Email: amy.tao@cornerstonefs.co.nz WeChat: Amytaoingrace