Interesting find about medicare supplements (medigap):
https://www.ehealthinsurance.com/medicare/parts/how-to-pick-the-best-medicare-supplement-plan-in-five-simple-steps/
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Except it is really cheap. I think I only paid $5/mo for 3 of us to have coverage when I worked for the fed gov. It covered the exams, glasses, and then some extra glasses for work.
I paid for the premium plan for the 3 of us, $50/mo, but it covered $4000 per person per year. Paid for two sets of braces, one set of wisdom teeth removal and lots and lots of work for me, including two implants.
For my MA choices, one pays up to $4000/yr for dental and the vision plans donāt look too bad. Of course, MA is no cost to me so it is all good. Iād have to price it out if I chose a supplement plan, but since Iām doing MA, I just have to pick which benefits I think are best for me.
True, it is cheap, but you get what you paid for pretty much. In our experience, if employer covered it, fine, if not, $10 a month was about the same as VSP would cover. Plus, very few providers in our area were taking VSP. We just go to Costco for our vision exams and Mr.ās glasses.
Employer-based insurance is often heavily subsidized by the employer. If you have to pay the full price of the plan, it would be considerably less attractive from a financial standpoint.
Iāve never seen a dental plan that would cover braces. The braces are covered by orthodontia rider. Separate from dental coverage. Most dental plans we had typically included $2-4K of lifetime coverage specifically for braces for kids under 18.
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I donāt think the gov paid any of the premium. It was really weird how my agency covered things. We had 5 or 6 choices for medical insurance and it paid $x amount, so if you picked Blue Cross you had to pay more. IIRC, the dental and vision were not paid for by agency. My dental was about $50/mo, and my health insurance was about $55. Many more claims by my family for dental.
D has $2,000 lifetime orthodontia as an adult through her Hās insurance. She just got Invisalign because a good portion is covered (she had braces, but she didnāt wear her retainerā¦). Both my H & I had adult and child orthodontia coverage on our work plans, but only $1,000. It was $1,000 when our kids used it 20+ years ago - Iām sure $1,000 doesnāt go nearly as far today.
We no longer have dental insurance, but our long-time dentist offers an in-office plan. It costs the same as two ācashā cleanings, and it includes X-rays and 20% off cash prices for any necessary work. Itās a good deal.
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That sounds about the same as our plansā¦ WA and CA.
I did pay for the āpremiumā plan (I think otherwise it would have been $20/mo and covered $2500/person/yr, so maybe the ortho was in that premium policy, and my kids were under 18.
Every time Iād go to the dentist, theyād say āOh, this wonāt be coveredā and Iād say āJust try to bill it and weāll seeā and more often than not it was covered (things like a ā180 xrayā that was going to cost $225 was covered at $185, and dentist was a preferred provider so had to take it)
Government plans are usually more generous. I wonder if some agencies self-insure. One of my husbandās employers did. Aetna was just the plan administrator. That was the time when we had the best coverage! 
But anyway, back to Medicare. I dread the time I will have to pester Mr. to apply. He hates red tape and filling out forms!
It is fairly common for medium and large employers to self-insure for employee medical costs, using the usual medical insurance companies to administer the plan.
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Iām on a self insured local govt policy. They are very open about what they pay vs the employee for all of our benefits. They donāt pay anything for dental/vision. When I signed up it would break even if all 4 of us went twice/year, and then it will pay some if we have problems. But itās limited to $1000/yr for things like crowns, root canals. We got $1000 per kid for braces. They were $5-6K back then.
We pay about $150/month for the premium plan. I pay almost $400/month for a $5K per person high deductible plan. If I went to the $2000 deductible, more traditional plan it would be nearly $1000/month. Which is all still better than (elementary teacher) Hās $2000/month family health insurance plan.
My husbandās dental plan at his work covered braces. And big surpriseā¦our kid had gotten her braces already, and they covered the balance we owed. It was a great plan.
Off topic to this threadā¦
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It is a dental plan with an orthodontia add on. It is NOT a purely dental plan. See above. 
It covered orthodontiaā¦and we didnāt pay extra for a rider. This was about 20 years ago!
Yes. It did, but that was a dental plan with an automatic orthodontia add on. the reimbursement went through that special rider included in your plan. One should never assume a dental plan would cover braces or anything related to braces.
Back to our regular programming.
Back when my children needed braces, we were often quoted two completely different prices. If paid by insurance, the total was higher, and our portion was nearly the same as if we paid direct without insurance. Having insurance did not help much at all.
We also have VSP currently through employer. I have yet to figure out their coverage. In the past, VSP would cover the vision portion, and medical insurance would cover the eye exam (dilation, glaucoma check, etc.). I recently had a vision only exam at the same optometrist (Eye exam was done with a specialist elsewhere). They said VSP would not pay for the vision exam because it was not paired with the eye exam. HUH?
Supposedly VSP covers new glasses every other year (up to a defined dollar amount), and lens changes every year. I have yet to see that work correctly.
We plan do the same as bunsenburner and self-insure for vision at least. Not yet sure about dental.
Employers can buy different levels of VSP coverage, so what you got in the past through VSP may be different from what you get now.
Vision deteriorates slowly over time. My glasses guy said that many of his seniors purchase an individual VSP plan every other year, so they get an exam and glasses at that time.
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To bring this back to MA, my motherās plans for vision and dental changed quite a bit in the last year (2022). Sheād been getting some dental and a discount on glasses, but I know in 2022 she got quite a bit more covered in dental and at least one full pair of glasses. She was very surprised because sheād switched dentists and the new one was pretty āfancyā (and much closer to our house) but she didnāt owe anything after a cleaning, cracked tooth and a few other things.
Weāll see whatās up as Iām comparing all the options now.