As an FCA-authorised private medical insurance broker that has helped arrange over 800,000 policies, WeCovr knows the UK market inside and out. A common question we hear is: "Should I add dental and optical cover to my policy?" It’s a smart question. Let's explore when it's worth the extra cost.
WeCovr explains when to include dental and optical cover in PMI
Private Medical Insurance (PMI) is your health safety net, designed to give you fast access to high-quality medical care for acute conditions. But what about your teeth and eyes? Standard PMI policies typically don't cover routine check-ups, fillings, or new glasses. For that, you need to consider an 'add-on' or 'option'.
Deciding whether to include dental and optical cover is a personal choice that hinges on your individual needs, your family's health, and your budget. It's a classic cost-benefit calculation. You're weighing the certainty of a fixed monthly premium against the potential for unexpected, and often costly, dental or optical bills.
At WeCovr, we believe in empowering you with clear information. This guide will walk you through everything you need to know to make the right decision for you and your loved ones.
What Exactly Are Dental and Optical Add-Ons?
Think of your core private health cover as the main course. Dental and optical add-ons are the side dishes you can choose to complete your meal. They are optional extras that you pay a higher monthly premium for, which in turn provides cover for a range of treatments for your teeth and eyes.
These add-ons are not standalone insurance policies. They are integrated into your main PMI plan and are offered by the same provider, such as Aviva, Bupa, or Vitality.
Typically, these add-ons work on a cashback or reimbursement basis:
- You visit your dentist or optician.
- You pay for the treatment or service upfront.
- You submit the receipt to your insurance provider.
- The insurer reimburses you up to the annual limits set out in your policy.
It’s crucial to understand that these add-ons come with specific limits and levels of cover. They aren't an unlimited pass for all treatments.
Understanding the NHS Baseline for Dental and Optical Care in the UK
Before you can decide if private cover is worth it, you need to understand what you're already entitled to through the NHS. The NHS provides excellent care, but it isn't always free, and access can sometimes be a challenge.
NHS Dental Services
In England, NHS dental treatment is categorised into three main bands. (Prices are illustrative for 2025 and are subject to change by the government).
| Band | Includes | Illustrative Cost (2025) |
|---|
| Band 1 | Examination, diagnosis (including X-rays), scale and polish (if needed), preventive care (e.g., fluoride varnish). | ~£26.80 |
| Band 2 | Everything in Band 1, plus further treatments like fillings, root canal work, or tooth removal. | ~£73.50 |
| Band 3 | Everything in Bands 1 and 2, plus complex procedures like crowns, dentures, and bridges. | ~£319.10 |
Source: NHS England pricing structure.
The biggest challenge with NHS dentistry isn't always the cost, but access. The British Dental Association has highlighted significant difficulties for patients trying to find an NHS dentist accepting new adult patients, creating what many call 'dental deserts' in parts of the UK. This lack of access often forces people to turn to private dentists, where costs are considerably higher.
NHS Optical Services
NHS optical services are more limited for most adults.
- Free Eye Tests: You are entitled to a free NHS eye test if you are under 16, aged 60 or over, are registered as partially sighted or blind, have been diagnosed with diabetes or glaucoma, or meet certain other criteria (e.g., receiving certain benefits).
- Optical Vouchers: If you qualify, the NHS provides vouchers towards the cost of glasses or contact lenses. The value of the voucher depends on the strength of your prescription.
For most working-age adults, an eye test will cost between £20-£30, and the cost of glasses can range from under £50 to several hundred pounds, depending on the frames and lenses chosen.
How Do PMI Dental Add-Ons Work?
When you opt for a dental add-on, you'll usually find it's structured in tiers. More comprehensive cover costs more.
Here's a breakdown of what you might find:
Level 1: Routine Cover (The Basics)
This is the entry-level option, designed to help with predictable costs.
- Check-ups: Covers the cost of your six-monthly or annual examination.
- Scale and Polish: Includes professional cleaning by a hygienist.
- X-rays: Covers diagnostic imaging.
- Minor Fillings: May cover a small contribution towards simple fillings.
Level 2: Mid-Range Cover (Routine + Restorative)
This level includes everything in Level 1, plus cover for more significant work.
- Fillings: Higher limits for fillings.
- Extractions: Removal of teeth.
- Root Canals: Treatment for infected tooth pulp.
- Crowns, Bridges, Dentures: A contribution towards major restorative work.
Level 3: Comprehensive Cover (Including Major & Emergency)
The top tier of cover.
- Higher Annual Limits: Significantly more money available per year for all treatments.
- Orthodontics: Some policies may offer a contribution towards teeth straightening for adults or children, though this is less common and often has strict criteria.
- Dental Emergencies: Cover for urgent treatment needed due to an accident or sudden pain.
- Dental Implants: May offer a contribution towards the high cost of implants.
A Crucial Point on Pre-existing Conditions: It's vital to understand that standard UK private medical insurance, including any add-ons, is designed to cover acute conditions that arise after you take out the policy. If you have a long-standing issue with a tooth that needs a crown, a PMI dental add-on is unlikely to cover it. The cover is for future, unforeseen problems.
How Do PMI Optical Add-Ons Work?
Optical cover is generally simpler than dental. It's designed to contribute towards the regular costs associated with maintaining your vision.
What's Typically Included?
- Eye Tests: Reimbursement for the cost of a private eye test, usually once every one or two years.
- Glasses/Spectacles: A fixed amount towards the cost of new prescription glasses. For example, a policy might offer £150-£200 per two-year period.
- Contact Lenses: A contribution towards the cost of prescription contact lenses.
What's Usually Excluded?
- Laser eye surgery (this is often a separate, high-cost benefit on premium PMI plans, not part of a standard optical add-on).
- Non-prescription sunglasses.
- Cosmetic treatments.
The value here is in its consistency. If you know you and your family will all need new glasses every two years, an optical add-on can help budget for that predictable expense.
This is the million-dollar (or perhaps, hundred-pound) question. The answer depends entirely on your circumstances. Let's run through some scenarios to help you decide.
A Simple Cost-Benefit Analysis
Imagine a dental and optical add-on costs you an extra £30 per month, which is £360 per year.
What would that £360 need to cover to be "worth it"?
- Private Dental Check-up & Hygienist: ~£120
- One Small Filling: ~£90
- Private Eye Test: ~£25
- Contribution to Glasses (£200 value): Let's say you get this every two years, so the annual value is £100.
Total Annual Private Cost: £120 + £90 + £25 + £100 = £335
In this very specific scenario, the £360 premium is slightly more than your expected costs. However, it provides peace of mind. What if you needed a root canal, which can cost £500-£1,000 privately? The insurance would then represent a significant saving.
Conversely, if you have good teeth, find an NHS dentist, and only need new glasses every three years, the £360 annual cost might feel like poor value.
Scenario 1: When Dental & Optical Cover Makes Financial Sense
You should strongly consider adding these options if you fall into one of these categories:
-
Families with Children:
- Children often need regular check-ups.
- Orthodontic (braces) needs can arise. While full cover is rare, some PMI add-ons provide a contribution which can be very helpful against costs that can run into thousands.
- The convenience of booking family appointments at a private clinic can be a huge time-saver.
-
Those Unable to Find an NHS Dentist:
- If you live in a 'dental desert' and your only option is to go private, this add-on becomes almost essential. It helps you budget for guaranteed private care without facing a huge one-off bill.
-
Individuals with a History of Dental Issues:
- Important Caveat: This applies to new issues. As mentioned, pre-existing conditions aren't covered. However, if you generally have 'weak' teeth and know that you're likely to need fillings or other restorative work in the future, the add-on acts as a sensible budgeting tool.
-
Higher Earners Who Value Convenience:
- For busy professionals, the ability to get a quick private appointment that fits their schedule can be more valuable than the monetary saving itself. The add-on simplifies the process and cost.
Scenario 2: When You Might Not Need an Add-On
It might be better to save the premium and 'pay as you go' if:
-
You Have Stable NHS Dental Access:
- If you are registered with a reliable NHS dentist and are happy with the service, the costs are capped and predictable. The extra premium for a private add-on may not be justified.
-
You Have a Tight Budget:
- If you're looking for the most affordable private medical insurance UK has to offer, your priority should be the core policy covering major health events like cancer care or surgery. Dental and optical are 'nice-to-haves' that can be cut to make the essential cover more affordable.
-
You Have Excellent Dental and Optical Health:
- If you rarely need fillings and your eyesight is stable, you might only spend £50-£100 a year on check-ups. Paying a £300+ premium in this case doesn't add up financially.
-
You Prefer a Standalone Cash Plan:
- Health cash plans are a different type of product. You pay a monthly fee and can claim back cash for NHS and private dental/optical costs. They can sometimes offer better value for money if routine care is your only concern. An expert PMI broker like WeCovr can discuss these alternatives with you.
Comparison: PMI Add-On vs. Standalone Plan vs. Pay As You Go
| Feature | PMI Add-On | Standalone Dental/Cash Plan | Pay As You Go |
|---|
| Integration | Part of your main health insurance policy. One provider, one payment. | A separate policy from a specialist provider. | No policy, no monthly cost. |
| Best For | Convenience and covering a mix of routine and unexpected major treatments. | Budgeting for predictable routine costs (NHS or private). | People with low dental/optical needs or good NHS access. |
| Cost | Adds £20-£50+ per month to your PMI premium. | Typically £10-£40 per month. | Pay only for what you use, when you use it. |
| Cover Focus | Often provides higher limits for major restorative work (crowns, bridges). | Usually focused on reimbursement for routine check-ups, hygienist visits, and glasses. | Unlimited, but funded entirely from your own pocket. |
| Simplicity | High. Everything is managed under one policy. | Medium. You have a separate policy and provider to deal with. | High. No paperwork, just pay the bill. |
Major UK PMI Providers and Their Dental & Optical Offerings
Most major UK providers offer these add-ons, though the specifics vary.
- Aviva: Often provides a range of dental and optical options that can be added to their Healthier Solutions policies, with clear annual limits.
- Bupa: Bupa By You policies allow for the addition of a dental plan, which can cover routine care, treatment, and even emergencies.
- AXA Health: Their Personal Health plans typically include options to add dental and optical cover, often on a cashback basis.
- Vitality: Known for its wellness-oriented approach, Vitality often links dental and optical benefits to healthy living activities, providing rewards and discounts.
The key is not to assume they are all the same. The annual limits, the types of treatment covered, and the monthly cost can differ significantly. This is where working with an experienced PMI broker is invaluable. WeCovr can compare the fine print from each leading provider to find the plan that truly fits your needs.
Wellness Corner: Proactive Steps for Dental and Oral Health
Insurance is there for when things go wrong, but the best strategy is prevention. A healthy lifestyle can significantly reduce your need for dental and optical treatments.
- Diet is Key: Sugary foods and acidic drinks (like fizzy pop and fruit juices) are the biggest enemies of tooth enamel. A balanced diet rich in calcium (dairy, leafy greens) and vitamin D helps build strong teeth and bones. For eye health, foods rich in antioxidants, Omega-3, and vitamins C and E—like fish, nuts, and colourful vegetables—are beneficial.
- Master Your Brushing Technique: Brush for two minutes, twice a day, with a fluoride toothpaste. Don't rinse with water straight after brushing, as this washes the protective fluoride away.
- Don't Forget to Floss: Flossing or using interdental brushes removes plaque from between teeth, where a regular toothbrush can't reach. This is crucial for preventing gum disease.
- The 20-20-20 Rule: To reduce digital eye strain, every 20 minutes, look at something 20 feet away for 20 seconds. This helps your eye muscles relax.
- Wear Sunglasses: Protect your eyes from UV damage, which can contribute to cataracts and other eye conditions later in life.
By taking these simple steps, you're not just saving money on future treatment; you're investing in your long-term health and wellbeing.
The WeCovr Advantage: Getting It Right
Navigating the world of private health cover can be complex. The options, exclusions, and pricing structures can feel overwhelming. This is where we come in.
As an independent and FCA-authorised broker, WeCovr works for you, not the insurance companies. We provide impartial, expert advice to help you build the perfect policy.
- Market-Wide Comparison: We compare plans from all the best PMI providers to find the right cover at the right price.
- No Extra Cost: Our advice and services are completely free to you. We are paid by the insurer, but our guidance remains 100% impartial.
- Value-Added Benefits: When you arrange a policy through us, you gain complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to support your health goals. Furthermore, our clients often receive discounts on other types of insurance, such as life or income protection cover.
- High Customer Satisfaction: Our focus on clear, honest advice has earned us high ratings from our clients. We're here to build a long-term relationship based on trust.
Choosing whether to add dental and optical cover is a significant decision. Let us help you make it with confidence.
Will my dental and optical add-on cover pre-existing conditions?
No, this is a critical point to understand. Standard UK private medical insurance, including dental and optical add-ons, does not cover pre-existing conditions. This means any dental or optical issue you have been treated for or sought advice on in the years before your policy starts will be excluded. The cover is for new, acute conditions that arise after your policy is in force.
Is there a waiting period before I can claim on my dental or optical cover?
Yes, most insurers apply an initial waiting period, or 'moratorium', before you can claim for certain treatments. For routine dental and optical care, this might be around 3-4 months. For major dental work like crowns or bridges, the waiting period could be longer, sometimes up to 12 months. This is to prevent people from taking out a policy to cover treatment they already know they need.
Are there annual limits on how much I can claim?
Absolutely. All dental and optical add-ons come with annual financial limits. For example, a policy might offer up to £250 for routine dental care, £750 for restorative work, and £150 for optical expenses per policy year. It's essential to check these limits when comparing policies, as they directly impact the value you can receive from the add-on. A cheaper premium often means lower annual limits.
Can I use any dentist or optician I want?
Generally, yes. Most PMI add-ons in the UK give you the freedom to choose any registered dentist or optician for your treatment. However, some insurers may have a network of 'partner' or 'approved' specialists. While you can usually go outside this network, staying within it might sometimes offer administrative benefits, like direct billing, so you don't have to pay upfront. Always check your policy documents for any network restrictions.
Ready to find the right health insurance policy for you?
The decision is easier with an expert on your side. Get a free, no-obligation quote from WeCovr today, and let our specialists compare the market to find the perfect cover for your needs and budget.