Top Reasons to Add Dental and Optical Cover to Your PMI
As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands that choosing the right private medical insurance in the UK can feel complex. A standard policy is a powerful tool for your health, but upgrading it with dental and optical cover can unlock a new level of comprehensive wellbeing.
WeCovr explains the benefits of upgrading your health policy
Private Medical Insurance (PMI) is designed to provide you with swift access to high-quality diagnosis and treatment for acute medical conditions. It’s a safety net, offering peace of mind and control over your healthcare journey. However, a standard PMI policy has a specific focus. It typically does not cover routine, everyday health needs like dental check-ups or eye tests.
This is where optional add-ons come in. By adding dental and optical cover to your policy, you are not just buying insurance for your teeth and eyes; you are investing in a holistic approach to your health, managing your budget, and bypassing potential NHS waiting times. This guide will explore the compelling reasons why this upgrade is one of the smartest decisions you can make for your private health cover.
Understanding the Core of Private Medical Insurance (and its limits)
Before we explore the benefits of add-ons, it’s crucial to understand what a standard private medical insurance UK policy is designed for.
What Standard PMI Covers:
The primary purpose of PMI is to cover the cost of treatment for acute conditions that arise after you’ve taken 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.
Examples include:
- Diagnostic tests like MRI or CT scans to investigate new symptoms.
- Surgical procedures, such as hernia repairs or joint replacements.
- Consultations with specialists.
- Hospital stays in a private room.
- Cancer treatment, which is often a core and highly valued benefit.
The Critical Exclusions: Chronic and Pre-existing Conditions
This is the most important distinction to grasp. UK private health cover is not designed to cover:
- Pre-existing Conditions: Any medical condition you had symptoms of, received advice for, or were treated for before your policy start date.
- Chronic Conditions: Long-term conditions that cannot be cured, only managed. This includes illnesses like diabetes, asthma, high blood pressure, and arthritis.
Your PMI policy is there for the new and unexpected, not for the ongoing management of a known condition. This same principle extends to routine maintenance. Standard policies will not typically pay for your annual dental check-up or your biennial eye test, as these are considered predictable, preventative care rather than treatment for an acute condition.
The Undeniable Link: How Oral and Eye Health Impact Overall Wellbeing
Your mouth and eyes are more than just features; they are windows into your overall health. Neglecting them can have consequences that ripple throughout your body.
The Mouth-Body Connection
Poor oral hygiene is not just about cavities or gum disease (gingivitis). A growing body of scientific evidence highlights a strong link between oral health and serious systemic diseases.
- Cardiovascular Disease: Bacteria from inflamed gums can enter the bloodstream, potentially leading to inflammation of the blood vessels, increasing the risk of heart attack and stroke.
- Diabetes: The relationship is a two-way street. Gum disease can make it harder to control blood sugar levels, and individuals with diabetes are more susceptible to infections, including gum disease.
- Respiratory Infections: Bacteria from the mouth can be inhaled into the lungs, potentially causing infections like pneumonia, especially in individuals with a weakened immune system.
- Dementia: Some studies have suggested a link between the bacteria that cause gingivitis and an increased risk of developing Alzheimer's disease.
Regular dental check-ups are not just for a scale and polish; they are a vital screening tool for your general health.
The Eyes: A Window to Your Health
Similarly, a routine eye test can detect far more than just your need for a new prescription. An optometrist can spot the early signs of several major health conditions by examining the tiny blood vessels, nerves, and tissues at the back of your eye.
- Diabetes: Diabetic retinopathy, where high blood sugar damages the blood vessels in the retina, is a leading cause of blindness in the UK but can be detected early during an eye test.
- High Blood Pressure (Hypertension): An eye exam can reveal bends, kinks, or bleeding from the tiny blood vessels in the retina, a clear sign of hypertension.
- High Cholesterol: Yellowish deposits around the cornea can be a sign of high cholesterol levels.
- Glaucoma: This condition damages the optic nerve and often has no symptoms in its early stages. A routine eye test is the best way to catch it before significant vision loss occurs.
Investing in regular check-ups is one of the most proactive steps you can take for your long-term health.
The Reality of NHS Access: Costs and Waiting Times
While the NHS provides an essential service, accessing dental and optical care can be challenging and is not always free. This is a primary driver for many people considering private options.
The NHS Dental Dilemma
Finding an NHS dentist accepting new adult patients has become notoriously difficult in many parts of the UK. A 2024 report from the British Dental Association highlighted that the vast majority of practices are not in a position to take on new NHS patients, leading to "dental deserts".
Even if you have an NHS dentist, the treatment is not free for most adults. The costs are categorised into bands (figures below are illustrative for 2025):
| NHS Dental Charge Band (England) | Treatments Covered | Estimated Cost (2025) |
|---|---|---|
| Band 1 | Examination, diagnosis, scale and polish (if needed), X-rays, preventative advice. | £26.80 |
| Band 2 | All Band 1 treatments, plus fillings, root canal work, and tooth extractions. | £73.50 |
| Band 3 | All Band 1 & 2 treatments, plus complex procedures like crowns, dentures, and bridges. | £319.10 |
Source: NHS England guidance, projected figures for 2025.
Facing a Band 3 charge for a single crown can be a significant, unexpected expense. Private dental cover helps you budget for these costs with a predictable monthly premium.
NHS Optical Services
Free eye tests on the NHS are generally limited to specific groups:
- Children under 16 (or under 19 and in full-time education).
- Adults aged 60 and over.
- Those diagnosed with diabetes or glaucoma.
- People receiving certain benefits.
Many working-age adults do not qualify and must pay privately for an eye test, which can cost between £25 and £40. While NHS vouchers are available to help with the cost of glasses or contact lenses, the eligibility criteria are similar, and the voucher value may not cover the full cost of modern, comfortable frames and lenses.
Diving Deep: What Does a Dental Insurance Add-on Cover?
When you add dental cover to your PMI policy, you’re essentially buying a plan that reimburses you for a portion of your dental costs, up to an annual limit. The level of cover can vary significantly between providers, but it's typically broken down into categories.
Levels of Dental Cover Explained
| Feature | Level 1: Routine Cover | Level 2: Mid-Range Cover | Level 3: Comprehensive Cover |
|---|---|---|---|
| Routine Treatments | ✅ Check-ups, scale & polish, X-rays, minor treatments | ✅ All of Level 1 | ✅ All of Level 1 |
| Restorative Treatments | ❌ (or very limited cover) | ✅ Fillings, extractions, root canals | ✅ All of Level 2 |
| Major Treatments | ❌ | ❌ (or limited contribution) | ✅ Crowns, bridges, dentures |
| Accidental Injury | ✅ (Often included) | ✅ | ✅ |
| Oral Cancer | ❌ (Covered by core PMI) | ❌ (Covered by core PMI) | ❌ (Covered by core PMI) |
| Orthodontics | ❌ | ❌ | ➕ (Sometimes available as a further upgrade) |
| Typical Annual Limit | £250 - £500 | £500 - £1,000 | £1,000 - £2,500+ |
Important Considerations:
- Waiting Periods: You may not be able to claim for major restorative work (like a crown) for the first 3-6 months of your policy. Routine check-ups are often covered immediately.
- Annual Limits: This is the maximum amount you can claim back in a policy year. It's important to choose a limit that reflects your likely needs.
- Pay and Claim vs. Direct Settlement: Some insurers require you to pay your dentist upfront and then claim the money back. Others have a network of dentists where they can settle the bill directly, which is more convenient.
A skilled PMI broker like WeCovr can help you navigate these options, comparing the annual limits, waiting periods, and claim processes of the best PMI providers to find the perfect fit for you.
Unpacking Optical Insurance: Seeing the Value Clearly
Optical cover operates in a similar way to dental cover. It's an affordable add-on designed to cover the predictable costs associated with maintaining your eye health and vision.
What Optical Cover Typically Includes:
- Eye Tests: The full cost of a routine eye test with an optometrist, usually once every two years unless clinically necessary more often.
- Glasses and Contact Lenses: A fixed contribution towards the cost of new prescription eyewear. This amount can range from £100 to over £250 per policy year, depending on your level of cover.
Here is a simple breakdown:
| Feature | Typical Optical Cover |
|---|---|
| Routine Eye Tests | ✅ Covered in full (e.g., up to £30) |
| Contribution to Glasses | ✅ £100 - £250 allowance per policy year |
| Contribution to Contact Lenses | ✅ £100 - £250 allowance (usually shared with glasses) |
| Specialist Cataract Consultations | ✅ (Surgery itself is usually covered by core PMI) |
| Typical Annual Premium (Add-on) | £5 - £10 per month |
While the surgery for conditions like cataracts is almost always covered under a core PMI policy, the optical add-on covers the initial diagnostic pathway—the eye tests and consultations that identify the problem in the first place.
The Financial Case: A Real-World Cost vs. Benefit Analysis
Is it financially sensible to pay an extra premium each month? Let's look at a practical example.
Meet Alex: A Case Study
Alex is a 35-year-old professional. They decide to add a mid-tier dental and optical plan to their PMI policy for an additional £20 per month (£240 per year).
Here’s their usage over one policy year:
- Two private dental check-ups with a hygienist visit: £90 x 2 = £180
- One filling discovered during a check-up: £150
- One private eye test: £30
- A new pair of glasses: £220
Total cost without insurance: £580
With their policy, Alex's experience is different:
- Their dental cover has a £750 annual limit and covers 100% of routine and restorative care.
- Their optical cover includes a free eye test and a £150 contribution to glasses.
Alex's costs with insurance:
- Dental check-ups and filling: £0 (fully covered within the limit)
- Eye test: £0 (covered)
- New glasses: £220 - £150 (allowance) = £70
- Total out-of-pocket cost: £70
When we add the annual premium, Alex's total spend is £240 (premium) + £70 (glasses) = £310.
In this realistic scenario, Alex saved £270 (£580 - £310) and gained the peace of mind of having their care covered. The add-on more than paid for itself.
The WeCovr Advantage: More Than Just Insurance
Choosing WeCovr for your private health cover provides additional benefits designed to support your wellness journey.
- CalorieHero App: All our health and life insurance clients receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, helping you stay on top of your health goals.
- Multi-Policy Discounts: When you take out a PMI or life insurance policy with us, you become eligible for exclusive discounts on other types of insurance, such as home or travel cover, saving you more money in the long run.
- Exceptional Service: We pride ourselves on our high customer satisfaction ratings, achieved by providing clear, impartial advice and dedicated support throughout the life of your policy.
How to Add Dental and Optical Cover to Your PMI Policy
The process is straightforward. These benefits are almost always included as optional modules when you first set up your policy or at your annual renewal.
- Define Your Needs: Think about your dental history and whether you wear glasses. Do you anticipate needing just routine care, or is more complex work a possibility?
- Speak to a Broker: This is the most efficient step. An independent PMI broker like WeCovr has a comprehensive view of the market. We can present you with quotes from multiple leading insurers (like Bupa, AXA Health, Aviva, and Vitality) and clearly explain the differences in their dental and optical offerings.
- Compare the Details: We will help you look beyond the price. We'll compare annual limits, waiting periods, and whether the policy uses a "pay and claim" or "direct settlement" model.
- Select and Activate: Once you've chosen the best PMI provider and the right level of cover, the dental and optical benefits are simply added to your overall policy.
Using a broker costs you nothing extra; our commission is paid by the insurer you choose. Our role is to provide expert, unbiased advice to ensure you get the best possible value.
Frequently Asked Questions (FAQ)
Here are answers to some common questions about upgrading your private medical insurance.
1. Does standard private medical insurance cover dental and optical care? No, standard PMI policies in the UK are designed to cover acute medical conditions and do not typically include routine dental or optical care. These must be added as optional benefits, which involves an increase in your premium.
2. Can I get dental and optical cover for pre-existing conditions? Generally, no. Just like core PMI, the dental and optical add-on will not cover issues you are aware of when you join. For example, if your dentist has already told you that you need a crown, this would be considered a pre-existing condition and would not be covered. However, routine check-ups are usually covered from the start.
3. Is it cheaper to buy a standalone dental plan or add it to my PMI? It can be more convenient and is often more cost-effective to bundle dental and optical cover with your PMI policy. A broker can run a comparison for you, showing the costs of a bundled PMI plan versus a core PMI policy plus a separate standalone dental plan, allowing you to make an informed choice.
4. What are the typical annual limits on dental and optical cover? Annual limits vary significantly by provider and the level of cover chosen. For dental, routine plans may have a limit of around £500, while comprehensive plans can exceed £2,500. For optical, the benefit is usually structured as a contribution towards glasses or lenses, typically ranging from £100 to £250 per year.
Take the Next Step Towards Comprehensive Health Cover
Adding dental and optical benefits is a powerful way to transform your private medical insurance from a safety net for major health events into a comprehensive tool for your everyday wellbeing. It allows you to budget effectively, access care promptly, and take a proactive approach to your health.
At WeCovr, we make the process simple. Our expert advisors are ready to listen to your needs and compare policies from the UK's leading insurers to find the perfect solution for you and your family.
Contact WeCovr today for a free, no-obligation quote and discover how affordable comprehensive private health cover can be.
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
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