TL;DR
As a leading FCA-authorised UK broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance can be complex. A common question we encounter is whether optional extras, specifically dental and optical cover, are a worthwhile investment. This guide breaks down the costs, benefits, and alternatives.
Key takeaways
- Routine Care: Check-ups, consultations, scale and polish treatments.
- Restorative Treatment: Fillings, root canals, crowns, bridges, and dentures needed to restore function.
- Dental Emergencies: Immediate treatment required for pain relief.
- Dental Injuries: Treatment following an accident (e.g., a chipped tooth from a fall).
- Cosmetic Dentistry: Teeth whitening, veneers, and cosmetic orthodontics are almost always excluded.
As a leading FCA-authorised UK broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance can be complex. A common question we encounter is whether optional extras, specifically dental and optical cover, are a worthwhile investment. This guide breaks down the costs, benefits, and alternatives.
WeCovr explores whether these extras are worth the extra cost
When you build a private medical insurance (PMI) policy, you start with a core foundation and then add layers of cover to suit your needs and budget. Dental and optical benefits are two of the most popular, yet often debated, additions.
Are you paying for peace of mind, or are you better off saving that extra premium and paying for check-ups and glasses as you go? The answer isn't the same for everyone. It depends on your personal health, your family's needs, your view of NHS waiting times, and your financial situation. Let's delve into the details to help you make an informed choice.
Understanding Core Private Medical Insurance in the UK
Before we assess the extras, it's crucial to understand what a standard private health cover policy actually does. At its heart, UK PMI is designed to cover the costs of diagnosis and treatment for acute conditions that arise after you take out your policy.
An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Think of conditions like hernias, joint replacements, or cataracts.
Conversely, PMI does not cover chronic conditions. These are long-term illnesses that cannot be cured, only managed. Examples include diabetes, asthma, high blood pressure, and arthritis.
Crucial Point: Standard private medical insurance policies universally exclude pre-existing conditions – any ailment you had symptoms of, or received advice or treatment for, before your policy began. This principle also applies to most dental and optical add-ons.
A core PMI policy typically includes:
- In-patient treatment: When you are admitted to a hospital bed overnight.
- Day-patient treatment: When you are admitted for a procedure but do not stay overnight.
- Cancer cover: This is often comprehensive and a key reason people take out PMI.
Out-patient cover (for consultations and diagnostics that don't require a hospital bed) is frequently an optional extra itself, so it's vital to check what's included as standard.
What Are Dental and Optical Add-Ons?
These are separate modules you can bolt onto your core health insurance policy for an additional monthly premium. They work by providing a pot of money you can claim back for routine and emergency dental and optical care, up to set annual limits.
A Closer Look at Dental Cover
A dental add-on helps you manage the costs of keeping your teeth and gums healthy. Cover is usually tiered, with higher premiums unlocking more comprehensive benefits and higher claim limits.
What's Typically Included?
- Routine Care: Check-ups, consultations, scale and polish treatments.
- Restorative Treatment: Fillings, root canals, crowns, bridges, and dentures needed to restore function.
- Dental Emergencies: Immediate treatment required for pain relief.
- Dental Injuries: Treatment following an accident (e.g., a chipped tooth from a fall).
What's Usually Excluded?
- Cosmetic Dentistry: Teeth whitening, veneers, and cosmetic orthodontics are almost always excluded.
- Pre-existing Issues: Any dental problem that existed before you bought the policy will not be covered.
- Mouthguards: Unless prescribed for a medical condition like bruxism, these are rarely covered.
Here’s a simplified look at how different levels of dental cover might compare:
| Feature | Basic Level | Mid-Range Level | Comprehensive Level |
|---|---|---|---|
| Annual Limit | £250 - £500 | £750 - £1,000 | £1,500+ |
| Routine Check-ups | 100% covered up to £100 | 100% covered up to £200 | 100% covered up to limit |
| Restorative Treatment | 50-80% covered | 80-100% covered | 100% covered |
| Dental Emergencies | Included | Included, higher limit | Included, highest limit |
| Orthodontics | Excluded | Excluded or small contribution | May include a contribution |
| Approx. Monthly Cost | £10 - £18 | £19 - £28 | £29 - £45+ |
Unpacking Optical Cover
Similar to dental, an optical add-on provides a financial benefit towards eye care costs. It's generally simpler and less expensive than dental cover.
What's Typically Included?
- Eye Tests: The cost of a routine sight test with an optician.
- Glasses & Contact Lenses: A set amount you can claim towards the cost of new prescription eyewear. This is usually an annual or biennial benefit.
What's Usually Excluded?
- Laser Eye Surgery: This is a specialist procedure and is almost never covered by a standard optical add-on. Some insurers offer it as a separate, high-cost benefit.
- Designer Frames: The policy will contribute towards the cost of frames, but it won't cover the premium you pay for a specific brand name.
- Non-Prescription Sunglasses: Must be prescription eyewear to be eligible for a claim.
The structure is often straightforward:
| Feature | Typical Optical Add-On |
|---|---|
| Annual Limit for Claims | £150 - £300 |
| Eye Tests | 100% covered, up to ~£40 |
| Glasses & Lenses Contribution | £100 - £250 per year/two years |
| Approx. Monthly Cost | £5 - £12 |
The Cost vs. Benefit Analysis: Are They Worth It?
This is the central question. To answer it, we need to compare the annual premium cost against the potential out-of-pocket expenses you might face.
How Much Do These Add-Ons Cost?
As shown in the tables above, the cost can vary significantly. For a 40-year-old individual, a mid-range dental add-on might cost around £25 per month (£300 per year), and an optical add-on might be £8 per month (£96 per year).
Total Annual Cost for Both Add-Ons: ~£396
This figure is influenced by:
- Your Age: Premiums increase as you get older.
- Level of Cover: More generous limits mean higher costs.
- The Insurer: Prices differ between the best PMI providers like Aviva, Bupa, AXA Health, and Vitality.
Gauging the Value: A Numbers Game
Let's look at the typical costs of private dental and optical care in the UK in 2025.
Typical Private Dental Costs:
- Check-up & Hygiene (illustrative): £80 - £150
- White Filling (illustrative): £100 - £250
- Root Canal (illustrative): £400 - £900+
- Crown (illustrative): £650 - £1,200+
Typical Private Optical Costs:
- Eye Test (illustrative): £25 - £40
- Single-Vision Glasses (illustrative): £80 - £200+
- Varifocal Glasses (illustrative): £200 - £500+
Now, let's use these figures in some real-life scenarios.
Real-Life Scenarios
Scenario 1: Sarah, a 32-year-old professional
Sarah is healthy and visits the dentist for a check-up and clean every year. This year, she also needs a small white filling. She wears glasses and gets a new pair every two years.
- Annual Add-On Cost:
- Illustrative estimate: Dental (mid-level): £25/month = £300 per year
- Illustrative estimate: Optical: £8/month = £96 per year
- Illustrative estimate: Total Annual Premium: £396
- Out-of-Pocket Costs Without Cover:
- Illustrative estimate: Dental check-up & hygiene: £120
- Illustrative estimate: One white filling: £180
- Illustrative estimate: Eye test: £30
- Illustrative estimate: New glasses (biennial cost, so halved for annual): £180 / 2 = £90
- Total Annual Spend: £420
Verdict for Sarah: In this particular year, the add-ons would have saved her a small amount (£24). The real value comes if she needs more extensive work, like a crown. The £396 premium acts as a cap on her basic dental and optical spending, providing budget certainty.
Scenario 2: The Jones Family (2 adults, 2 children aged 9 and 12)
The Joneses want to ensure their family's dental health is covered. Both children need regular check-ups, and the 12-year-old has just been told they need glasses.
- Annual Family Add-On Cost: Family plans are often not just 4x the individual cost; insurers offer multi-person pricing. Let's estimate:
- Illustrative estimate: Dental (family): £70/month = £840 per year
- Illustrative estimate: Optical (family): £25/month = £300 per year
- Illustrative estimate: Total Annual Premium: £1,140
- Potential Out-of-Pocket Costs Without Cover:
- 4x Dental check-ups & hygiene: 4 x £100 = £400
- 1x Adult filling: £180
- 2x Child eye tests (often free on NHS, but let's assume private for speed/choice): 2 x £30 = £60
- 1x Adult eye test: £30
- 1x Child's new glasses: £100
- Illustrative estimate: 1x Adult's new glasses (biennial): £200 / 2 = £100
- Total Potential Spend: £870
Verdict for the Jones Family: Based on a routine year, paying-as-they-go seems cheaper. However, the insurance calculus changes dramatically if another family member needs glasses, or if one of the adults requires a crown (£800+) or root canal (£600+). For a family, the insurance provides a safety net against multiple, simultaneous costs.
The NHS vs. Private Dental and Optical Care
A key factor in this decision is your ability and willingness to use the NHS.
NHS Dental Services: The Reality in 2025
Whilst excellent in principle, accessing NHS dentistry has become increasingly difficult. A 2024 report from Healthwatch England highlighted that many people are struggling to find an NHS dentist accepting new patients, with some resorting to DIY dentistry or paying for private care they can't afford.
If you can access an NHS dentist, the costs are standardised into bands.
NHS England Dental Charges (Estimated for 2025):
| Band | Treatment Covered | Estimated Cost |
|---|---|---|
| Band 1 | Examination, diagnosis, scale and polish (if needed). | ~£26.80 |
| Band 2 | Covers everything in Band 1, plus fillings, root canals, and tooth extractions. | ~£73.50 |
| Band 3 | Covers everything in Bands 1 & 2, plus complex procedures like crowns, dentures, and bridges. | ~£319.10 |
The main draw of a private dental add-on is choice and access. It allows you to see a private dentist of your choice, often much more quickly, and with more flexible appointment times.
NHS Optical Services
Access to NHS optical services is generally much better. You are entitled to a free NHS sight test if you are:
- Aged 60 or over
- Under 16 (or 16-18 and in full-time education)
- Diagnosed with diabetes or glaucoma
- Receiving certain benefits (e.g., Universal Credit)
You may also be eligible for an NHS optical voucher to reduce the cost of glasses or contact lenses. However, the value of these vouchers may not cover the full cost, and your choice of frames will be limited. Private optical cover gives you the freedom to choose any optician and a wider range of eyewear.
Alternatives to Integrated Health Insurance Add-Ons
Before adding these extras to your PMI policy, consider the alternatives. They might be a better fit for your circumstances.
1. Standalone Dental Insurance Plans
These are dedicated insurance policies just for dental care, offered by specialists like Denplan or Bupa Dental. They function similarly to PMI add-ons but are not tied to a health insurance policy.
- Pros: Can sometimes offer more specialised or comprehensive dental benefits.
- Cons: Another policy to manage. May not be cheaper than an integrated add-on.
2. Health Cash Plans
Cash plans are a very popular alternative. You pay a monthly premium (e.g., £10 - £50) and can then claim back cash for a wide range of healthcare expenses, including dental, optical, physiotherapy, and prescriptions.
- Pros: Highly flexible. You can use your annual allowance across different types of treatment. You can use them for both NHS and private treatment costs.
- Cons: You always have to pay the provider first and then claim the money back. The annual limits may be lower than a dedicated insurance plan.
3. Self-Insuring (Paying As You Go)
This simply means paying for your dental and optical costs out of your own pocket as they arise.
- Pros: No monthly premium. You only pay for what you need.
- Cons (illustrative): You are fully exposed to the risk of a large, unexpected bill. A sudden need for a crown and a root canal could set you back over £1,500.
For this to work, it's wise to set aside a dedicated amount each month into a savings account, creating your own personal healthcare fund.
How WeCovr Can Help You Decide
Making the right choice requires a clear understanding of the market, the products, and your own needs. As an independent and FCA-authorised PMI broker, WeCovr provides impartial, expert advice at no cost to you.
We can:
- Analyse Your Needs: We'll discuss your health, family situation, and budget to determine if these add-ons make sense for you.
- Compare the Market: We have access to policies from all the leading UK insurers and can create a detailed comparison of core cover and the value offered by their respective dental and optical add-ons.
- Find the Best Value: We'll help you find the sweet spot between premium cost and benefit level, ensuring you don't overpay for cover you don't need.
Furthermore, clients who purchase PMI or Life Insurance through WeCovr gain complimentary access to our AI-powered nutrition app, CalorieHero, to support their wellness goals. We also offer attractive discounts on other types of insurance, helping you consolidate your protection and save money. Our consistently high customer satisfaction ratings reflect our commitment to finding the right solution for every client.
Top Tips for Healthy Teeth and Eyes
Whether you choose insurance or not, prevention is always the best policy.
Maintaining Your Oral Health
- Brush Twice Daily: Use fluoride toothpaste and brush for two minutes each time.
- Floss or Use Interdental Brushes: Clean between your teeth daily to remove plaque where a brush can't reach.
- Limit Sugary Foods and Drinks: Sugar is the main cause of tooth decay.
- Don't Smoke: Smoking is a major risk factor for gum disease and mouth cancer.
- Regular Check-ups: Visit your dentist as often as they recommend.
Protecting Your Vision
- Follow the 20-20-20 Rule: When using screens, look at something 20 feet away for 20 seconds every 20 minutes to reduce eye strain.
- Eat a Healthy Diet: Foods rich in vitamins C and E, zinc, and omega-3 fatty acids can help protect against age-related eye diseases. Think leafy greens, oily fish, and citrus fruits.
- Wear UV-Protective Sunglasses: Protect your eyes from sun damage, which can contribute to cataracts and macular degeneration.
- Schedule Regular Eye Tests: An eye test can detect not only changes in your vision but also early signs of health conditions like glaucoma, diabetes, and high blood pressure.
Frequently Asked Questions (FAQ)
Does private health insurance automatically include dental and optical cover?
Are pre-existing dental or eye conditions covered by these add-ons?
Is cosmetic dentistry like teeth whitening covered?
What's the difference between a health insurance add-on and a health cash plan?
Ready to explore your options?
Deciding on the right level of private health cover is a personal choice. For tailored advice that weighs the costs and benefits for your unique situation, speak to a WeCovr expert today. We’ll provide a free, no-obligation quote and help you build a policy that gives you true peace of mind.
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
