As an FCA-authorised broker that has helped over 900,000 customers find the right cover, WeCovr understands that navigating the world of private medical insurance in the UK can be complex. Many people wonder if their policy can help with routine costs like dental check-ups or new glasses. Let's explore.
Which PMI policies include dental and eye care extras
In the UK, standard Private Medical Insurance (PMI) policies are designed to cover the costs of treating acute medical conditions that arise after you take out your policy. Think of things like surgery for a hernia, specialist consultations for joint pain, or cancer treatment.
Routine dental and optical care, however, is not typically included as a core benefit.
Instead, most major UK PMI providers offer dental and optical cover as an optional add-on or extra. You choose to add this benefit to your core health policy, which will increase your monthly premium. These add-ons are designed to help you budget for and manage the costs of everyday healthcare for your teeth and eyes.
Providers that commonly offer these optional benefits include:
- Bupa
- Aviva
- AXA Health
- Vitality
- WPA
The key takeaway is that you must actively choose and pay for this extra cover; it's almost never included automatically. An expert PMI broker can help you compare these add-ons to see which offers the best value for your needs.
Understanding How Dental & Optical Cover Works with PMI
Adding dental and optical benefits to your private health cover might seem like a great idea, but it's vital to understand exactly what you're getting. The level of cover, the limits, and the exclusions can vary significantly between insurers.
It's an Add-On, Not Standard Cover
The fundamental reason dental and optical care are add-ons is that PMI's main purpose is to cover unexpected health issues. Routine check-ups and predictable expenses like new glasses fall outside this scope. By making them optional extras, insurers keep their core policies more affordable and allow you to tailor your cover to your specific priorities and budget.
When you add this benefit, you are essentially buying a limited amount of cover for specific dental and optical services, which you can claim back up to a set annual limit.
What's Typically Included in a Dental & Optical Add-On?
While every policy is different, most dental and optical extras are structured to cover two main areas: routine maintenance and unexpected treatments.
Typical Dental Cover
- Routine Check-ups: This includes your regular examinations, consultations, and hygiene appointments (scale and polish). Most policies cover 100% of the cost up to your annual limit.
- Dental Treatment: This covers necessary work to fix a problem, such as fillings, root canals, crowns, and extractions. The policy will usually pay a percentage of the cost (e.g., 80%) up to a sub-limit.
- Dental Emergencies: This is for immediate treatment needed due to an accident or injury, like repairing a chipped tooth after a fall.
- Dental X-rays: Usually covered when required as part of a diagnosis or treatment plan.
Typical Optical Cover
- Eye Tests: The cost of your routine sight test with an optician.
- Glasses & Contact Lenses: This is not a blank cheque for designer frames. The policy will provide a fixed contribution towards the cost of new prescription glasses or contact lenses, for example, £150-£200 per year.
Key Exclusions to Watch Out For
Understanding what is not covered is just as important as knowing what is. Exclusions are the insurer's way of managing risk and cost.
- Pre-existing Conditions: This is the golden rule of all PMI. If you had a dental or optical issue before your policy started, treatment for it will not be covered. For example, if you join a policy knowing you need a crown on a specific tooth, that work will be excluded.
- Cosmetic Treatments: Any treatment that is not clinically necessary is excluded. This includes teeth whitening, veneers purely for aesthetic reasons, and cosmetic bonding.
- Dental Implants: This is a major exclusion on many policies. Some high-end plans may offer a small contribution, but most standard add-ons will not cover the high cost of implants.
- Laser Eye Surgery: This is almost always excluded from standard optical add-ons. Some insurers offer a separate, high-cost benefit or a discount with a partner clinic, but it's not part of the regular cover.
- Orthodontics: Braces and other teeth-straightening treatments are often excluded, particularly for adults. Some family policies might offer a contribution towards orthodontics for children, but this is rare and usually has strict limits.
The Critical Distinction: PMI vs. Cash Plans vs. Standalone Dental Plans
When looking for dental and optical cover, you'll encounter three main types of products. Choosing the right one depends entirely on your needs and what you're trying to achieve.
| Feature | PMI with Dental/Optical Add-On | Health Cash Plan | Standalone Dental Insurance |
|---|
| Core Purpose | Comprehensive cover for major, acute medical conditions. The dental/optical part is a secondary benefit. | Helps you budget for everyday health costs by letting you claim cashback. | Specifically designed to cover a wide range of dental treatments, from routine to major. |
| How it Works | Integrated into your main PMI policy. Insurer pays for eligible private treatment. | You pay for treatment (NHS or private), then submit a receipt to claim cash back, up to an annual limit. | You get access to treatment, and the insurer pays the dentist directly or reimburses you for the cost. |
| Dental Scope | Good for routine care and minor treatments. Limited cover for major work like crowns. | Provides a fixed amount of cash back per year (e.g., £200) for any dental costs. Simple but limited. | Can be very comprehensive, with high limits for major work like implants and orthodontics (on top-tier plans). |
| Optical Scope | Provides a contribution towards eye tests, glasses, and contact lenses. | Provides a fixed amount of cash back per year (e.g., £150) for any optical costs. | Not applicable. |
| Major Medical | Excellent. This is its primary function (e.g., surgery, cancer care, consultations). | None. Does not cover private surgery or major hospital stays. | None. Covers dental only. |
| Best For... | Someone who wants comprehensive medical cover and the convenience of having all benefits under one policy. | People who want to budget for predictable costs (dental, optical, physio) and are happy using the NHS for major issues. | Someone who anticipates needing significant dental work or wants the highest level of dental-specific cover available. |
Example: If you need a hip replacement, your PMI policy is what you need. If you just want £150 back towards your new glasses and a dental check-up, a health cash plan could be a cost-effective choice. If you need complex root canal treatment and a crown costing £1,500, a standalone dental plan might be the best option.
A Closer Look at UK PMI Providers and Their Dental & Optical Options (2025)
The private medical insurance UK market is competitive, and each major provider has a slightly different approach to dental and optical cover. Below is an overview of what you can typically expect from the leading names.
Note: The details below are illustrative examples. Policy features and limits change, so it's crucial to get an up-to-date quote. An expert broker like WeCovr can provide the latest information from across the market.
AXA Health
AXA often frames their option as a "cashback" benefit.
- Add-On Name: Dentist and Optician Cashback.
- How it Works: Rather than the insurer paying for treatment directly, you pay your dentist or optician and then claim the money back from AXA, up to your annual limit.
- Typical Benefits:
- Dental: Covers routine check-ups, hygiene visits, and treatments. May also cover dental accidents.
- Optical: Covers eye tests and gives a set amount towards glasses or contact lenses.
- Limits: AXA usually offers different levels of cover, for example, a standard level with a £400 annual limit and an enhanced level with a higher limit.
Bupa
Bupa is one of the most recognised names in UK health insurance and offers dedicated dental add-ons.
- Add-On Name: Dental Cover (often with different levels, e.g., Dental Cover 10, Dental Cover 20).
- How it Works: Provides cover for both NHS and private dental treatment.
- Typical Benefits:
- Routine Care: Covers check-ups and scale and polish.
- Treatments: Pays for fillings, extractions, and root canals.
- Oral Cancer: Includes cover for oral cancer treatment as standard.
- Emergencies: Covers dental injuries and emergencies at home or abroad.
- Optical: Bupa's optical benefit is often separate or part of a broader wellness package, providing cashback for eye tests and eyewear.
Aviva
Aviva's "Healthier Solutions" policy allows you to add a comprehensive dental and optical benefit.
- Add-On Name: Dental and Optical.
- How it Works: A combined benefit that provides reimbursement for a range of services.
- Typical Benefits:
- Dental: Covers routine examinations, hygiene, general treatments, and emergency dental work.
- Optical: Covers routine sight tests and provides a fixed sum for prescription glasses or contact lenses.
- Structure: Aviva often has clear sub-limits, for example, up to £250 for routine dental, £600 for general treatment, and £200 for optical goods.
Vitality
Vitality is known for its innovative approach, linking insurance with a wellness programme that rewards healthy behaviour.
- Add-On Name: Optical, Dental & Hearing Cover.
- How it Works: This is an optional benefit that you can add to your policy. Your activity levels, tracked through their programme, can earn you rewards and discounts.
- Typical Benefits:
- Dental: Offers cashback on check-ups and treatments.
- Optical: Provides cashback on eye tests and eyewear. They also have partnerships with opticians for potential discounts.
- Hearing: Uniquely, their add-on often includes cover for hearing tests and contributions towards hearing aids.
- The Vitality Difference: By engaging with the wellness programme (e.g., tracking your steps, doing health checks), you can increase the amount of cashback you receive, making the cover more valuable the healthier you live.
Summary Comparison of Provider Offerings (Illustrative)
| Provider | Typical Add-On Name | Key Dental Benefits | Key Optical Benefits | Typical Annual Limit Structure |
|---|
| AXA Health | Dentist and Optician Cashback | 100% cashback for check-ups, percentage-based for treatments. | Cashback for eye tests and a fixed sum for glasses/lenses. | Combined annual limit per person (e.g., £400). |
| Bupa | Dental Cover | Full cover for check-ups, hygiene, and emergencies. Cover for restorative work. | Often a separate cashback benefit for eye tests and eyewear. | Separate limits for different types of dental work. |
| Aviva | Dental and Optical | Reimbursement for routine care, general treatments, and emergencies. | Reimbursement for eye tests and a fixed sum for glasses/lenses. | Clear sub-limits for each category (e.g., dental routine, dental treatment, optical). |
| Vitality | Optical, Dental & Hearing Cover | Cashback on treatments, with the potential to increase the amount through healthy living. | Cashback on eye tests and glasses. Partnerships for discounts. | A flexible cashback pot that can be boosted by wellness activities. |
Is Adding Dental and Optical Cover to Your PMI Worth It?
This is the million-dollar question, and the answer is highly personal. It depends on your health, your budget, and how you prefer to manage your finances.
The Case For Adding Cover
- Convenience and Simplicity: Having everything under one roof with one provider and one monthly payment is simple and easy to manage.
- Budgeting for the Unpredictable: While a check-up is predictable, needing an emergency root canal is not. An add-on helps smooth out these unexpected costs, preventing a large one-off bill.
- Encourages Preventative Care: If you know your check-ups are paid for, you might be more inclined to attend regularly. The latest data from the Office for National Statistics (ONS) shows that around half of UK adults visit the dentist regularly, meaning many could benefit from this nudge. Regular visits can catch problems early, saving you pain and money in the long run.
- Peace of Mind: Especially for families, knowing that accidental dental injuries (common in active children) are covered can provide significant peace of mind.
The Case Against Adding Cover
- The Cost-Benefit Analysis: You must do the maths. Calculate the annual cost of the add-on versus how much you typically spend on dental and optical care. If the extra premium is £300 a year, but you only spend £150 on a check-up and an eye test, you might be better off paying as you go.
- Low Annual Limits: The limits for treatment can be quite low. A policy might offer a £750 limit for major restorative work, but a single private crown can cost upwards of £800-£1,000. You would still be left with a significant amount to pay out-of-pocket.
- Better Value Elsewhere? A health cash plan might be a cheaper way to get money back on routine expenses. A standalone dental plan will almost certainly offer more comprehensive cover for complex dental work than a PMI add-on.
A Real-Life Example: Meet David
David is a 42-year-old software developer in Manchester. He's considering adding dental and optical cover to his PMI policy, which will cost him an extra £25 per month (£300 per year).
- David's Typical Annual Spend:
- Two private dental check-ups with hygiene: 2 x £85 = £170
- One eye test: £25
- New glasses (every two years, so average annual cost): £200 / 2 = £100
- Total Annual Spend: £295
In this scenario, the cost of the add-on (£300) is almost identical to his typical spending (£295). He's essentially pre-paying for his routine care. However, if in one year he unexpectedly needs a filling costing £150, his policy would cover most of it. The add-on then becomes a valuable safety net against unforeseen costs.
The decision depends on his risk appetite. Does he prefer the certainty of a fixed monthly cost, or is he happy to save the £300 premium and pay for treatments if and when they arise?
The WeCovr Advantage: Finding Your Perfect Fit
Trying to compare all these different policies, add-ons, cash plans, and standalone products can be overwhelming. This is where working with a specialist, independent PMI broker like WeCovr makes all the difference.
- Whole-of-Market Advice: We are not tied to any single insurer. We compare policies and add-ons from across the UK market to find the one that truly fits your needs and budget.
- Expert Guidance at No Cost: Our service is free to you. We earn a commission from the insurer you choose, but our advice remains impartial and focused on your best interests. We can help you perform that crucial cost-benefit analysis.
- Tailored Solutions: We take the time to understand your circumstances. We can help you decide whether a PMI add-on is right for you, or if you'd be better served by a separate cash plan or dental policy.
- Added Value: When you take out a PMI or Life Insurance 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 benefit from discounts on other types of insurance they may need.
A Note on Health, Wellness, and Prevention
Insurance is a safety net, but the best strategy is always prevention. Taking proactive steps to protect your dental and optical health can reduce your need to claim and improve your overall quality of life.
Protecting Your Smile
- Diet is Key: Reduce your intake of sugary foods and drinks, which are the primary cause of tooth decay. According to NHS guidance, limiting snacking between meals gives your saliva a chance to neutralise acid in your mouth.
- Master the Basics: Brush your teeth for two minutes, twice a day, with fluoride toothpaste. Don't forget to clean between your teeth with interdental brushes or floss.
- Stay Hydrated: Drinking plenty of water helps wash away food particles and keeps your mouth healthy.
- Don't Skip Check-ups: Regular visits allow your dentist to spot issues like cavities or gum disease before they become serious and painful.
Caring for Your Eyes
- Follow the 20-20-20 Rule: If you spend long hours in front of a screen, every 20 minutes, look at something 20 feet away for 20 seconds. This helps reduce digital eye strain.
- Eat for Your Eyes: A diet rich in leafy greens (like spinach and kale), oily fish (like salmon), and colourful fruits and vegetables provides vitamins and minerals like Lutein and Zeaxanthin, which are essential for eye health.
- Wear UV Protection: Always wear sunglasses with 100% UVA and UVB protection when outdoors. This helps prevent cataracts and other long-term damage.
- Regular Eye Tests: An eye test doesn't just check your vision. It's a vital health check that can detect early signs of conditions like glaucoma, diabetes, and even high blood pressure.
The Unspoken Rule of UK PMI: Pre-existing and Chronic Conditions
This is the single most important concept to understand about private medical insurance in the UK. Failure to grasp this leads to most of the disappointment and frustration customers experience.
PMI is designed to cover acute conditions that begin after your policy starts.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a broken bone, appendicitis, or a cataract that has developed recently.
- Pre-existing Condition: Any medical issue (or its symptoms) for which you sought advice, received treatment, or took medication in the years before your policy began. Most insurers use a 5-year timeframe. If you had treatment for a bad back 3 years ago, it is a pre-existing condition.
- Chronic Condition: A condition that is long-term and has no known cure. It can be managed but not resolved. Examples include diabetes, asthma, arthritis, and glaucoma.
Standard UK private medical insurance DOES NOT cover pre-existing or chronic conditions.
If you have a recurring problem with a tooth before taking out a policy, any treatment related to that tooth will be excluded. If you have been diagnosed with glaucoma, the ongoing monitoring and management will not be covered by a new PMI policy. The cover is for new, unexpected problems, not for managing existing ones.
Frequently Asked Questions
Is dental and optical cover included as standard in UK private medical insurance?
No, it is not. Standard private medical insurance (PMI) in the UK covers acute medical conditions like surgery or specialist consultations. Dental and optical care is typically offered as an optional add-on that you must choose to include in your policy, which will increase your premium.
Can I get PMI to cover a dental implant I already know I need?
No, you cannot. A dental problem that you are already aware of before taking out the policy is considered a 'pre-existing condition'. UK private medical insurance does not cover pre-existing conditions. Furthermore, dental implants are a specific exclusion on most standard dental add-ons, even for problems that arise after the policy starts.
Is it cheaper to get a PMI add-on or a separate dental insurance plan?
It depends entirely on your needs. For basic routine care, a PMI add-on or a health cash plan can be cost-effective. However, if you want comprehensive cover for major treatments like crowns, bridges, or orthodontics, a standalone dental insurance plan will likely offer better value and higher financial limits, even if its premium is higher.
Does private health insurance cover laser eye surgery?
Generally, no. Laser eye surgery is considered an elective procedure and is almost universally excluded from standard PMI policies and their optical add-ons. Some insurers may offer a discount with a partner clinic or a separate, high-cost cash benefit towards it, but it is not a covered treatment in the typical sense.
How does an expert PMI broker like WeCovr help?
An expert, independent broker like WeCovr acts as your specialist guide. We compare policies and add-ons from across the entire market to find the best fit for your specific needs and budget. We explain the complex terms, highlight key exclusions, and help you decide between a PMI add-on, a cash plan, or a standalone policy, all at no cost to you.
Finding the right level of health cover is a balancing act. While adding dental and optical cover to your PMI can offer convenience and peace of mind, it's essential to weigh the cost against the benefits and limitations.
Ready to find out what's right for you? Speak to one of our friendly experts at WeCovr today for a free, no-obligation quote and let us help you build the perfect private medical insurance plan.