Yes - if you are self-employed in North Carolina, you can absolutely get both dental and vision insurance. The key thing to understand is that you buy them as standalone plans rather than expecting them to come bundled inside your medical coverage. Routine dental care and eye care for adults are not part of a standard Health Insurance plan, so you add separate Dental Insurance and Vision Insurance on top - and the good news is that you can buy those directly from carriers at almost any time of year, not only during open enrollment.
Below is a plain-English walkthrough of what is and isn't included in a typical self-employed health plan, exactly how to get dental and vision coverage in North Carolina, what these plans usually cover, and a tax break most self-employed people don't realize applies to their dental and vision premiums.
Does self-employed Health Insurance include dental and vision?
For adults, usually no - not automatically. Under the Affordable Care Act (ACA), routine adult dental and adult vision are not treated as "essential health benefits." That means a standard Health Insurance plan is not required to include them, and most adult health plans do not cover routine cleanings, fillings, eye exams, glasses, or contact lenses. So if you are picturing the dentist-and-optometrist coverage you may have had through an old employer, that coverage typically came from separate dental and vision plans - not from the medical plan itself.
There is one important exception worth knowing: children's dental. Pediatric dental care is one of the ACA's essential health benefits, so plans that cover children will either include pediatric dental or make it available. Adult dental and adult vision, though, are on you to add.
This is why the honest answer to "does self-employed health insurance include dental and vision" is that your medical plan handles doctors, hospitals, and prescriptions; a separate dental plan handles your teeth; and a separate vision plan handles your eyes. Think of them as three building blocks you stack to create the coverage you actually want.
How self-employed people actually get dental and vision in North Carolina
North Carolina uses the federally run marketplace at HealthCare.gov for individual Health Insurance, and there are two practical ways for a self-employed person here to add dental and vision coverage.
1. A standalone dental plan added alongside a marketplace health plan
When you enroll in a marketplace Health Insurance plan, you can add a standalone dental plan at the same time. The catch is timing: on HealthCare.gov, a standalone marketplace dental plan can generally only be purchased at the same time you buy your marketplace health plan - it is added during that same enrollment, not tacked on by itself months later. Adult vision is generally not sold as a standalone marketplace product at all, so most people get their vision coverage through the second path.
2. Standalone dental and vision bought directly from a carrier
The more flexible route for the self-employed is to buy standalone dental and vision coverage directly from an insurance carrier, off the marketplace. These direct plans are available year-round, with no enrollment window - you do not have to wait for open enrollment, and you do not need a qualifying life event. This is often the simplest path because you can add dental, vision, or both at any point in the year, completely independent of what your medical plan is doing.
You can add dental and vision even if your medical coverage is not a marketplace plan
Because standalone dental and vision plans are sold on their own, they do not depend on where your medical coverage comes from. Whether you have a marketplace Health Insurance plan, coverage through a spouse, or another arrangement entirely, you can still add a standalone dental or vision plan directly from a carrier. That independence is part of what makes these plans convenient for self-employed people: they are a separate decision you can make - or change - whenever it makes sense for your household, without touching your medical plan.
If you are still deciding on your medical plan itself, it is worth getting that squared away first. You can read our companion guide on how to get Health Insurance when you're self-employed, then layer dental and vision on top. If you work on 1099s or as an independent contractor, the same building-block approach applies - see how 1099 and independent contractors get Health Insurance.
| Buying option | Through HealthCare.gov (marketplace) | Directly from a carrier (off-marketplace) |
|---|---|---|
| When you can enroll | Dental can be added only when you enroll in a marketplace health plan | Year-round - no enrollment window and no qualifying event needed |
| Dental available? | Yes, as a standalone marketplace dental plan bought alongside a health plan | Yes, as a standalone dental plan you can buy anytime |
| Adult vision available? | Generally not sold as a marketplace product | Yes, as a standalone vision plan you can buy anytime |
| Best for | People adding dental while they set up their marketplace medical plan | People who want vision, or who want to add dental on their own timeline |
What dental and vision plans typically cover
Dental and vision plans are usually inexpensive relative to medical coverage, but they are structured very differently from a health plan, so it helps to know what you are looking at before you buy.
Dental plans
Most standalone dental plans are built in tiers. Preventive care - routine cleanings, exams, and X-rays - is usually covered most generously, because insurers would rather pay for a cleaning than a root canal. Basic work such as fillings is typically covered at a lower level, and major work such as crowns, bridges, and dentures is covered at a lower level still. A few features to watch for:
- Annual maximum. Many dental plans cap how much they will pay out in a given year, so a large dental bill can still leave you with meaningful out-of-pocket cost.
- Waiting periods. Some plans make you wait before they will cover major work, which matters if you already know you have a crown or bridge on the horizon.
- Orthodontia. Braces and other orthodontic care are often a separate benefit or an optional add-on rather than something included by default.
- Network. Staying with an in-network dentist generally means lower costs, so it is worth checking that your dentist participates.
Vision plans
Standalone vision plans generally focus on routine eye care. A typical plan helps with an annual eye exam and provides an allowance toward glasses or contact lenses, sometimes with discounts on lens upgrades or a second pair. As with dental, the value of a vision plan depends heavily on whether your eye doctor is in-network and on how much routine eye care your household actually uses in a year.
What to compare before you buy
- Is your current dentist or eye doctor in the plan's network?
- What is the annual maximum, and does it fit the care you expect to need?
- Are there waiting periods on the work you are most likely to use?
- How does the monthly premium compare to what you would realistically spend paying cash?
The tax break most self-employed people miss on dental and vision
Here is the part that surprises a lot of self-employed people: the self-employed health insurance deduction does not stop at your medical premiums. Under the tax rules for the self-employed (IRC Section 162(l)), the IRS instructions for Form 7206 explicitly list "medical, dental, and vision insurance and qualified long-term care insurance" as eligible premiums. In other words, the premiums you pay for standalone dental and vision coverage can be deducted right alongside your Health Insurance premiums.
A few things to know about how this deduction works:
- It is an above-the-line deduction reported on Schedule 1 of Form 1040, so you do not have to itemize to take it.
- It can cover premiums for you, your spouse, your dependents, and any child who is under age 27 at year-end - even a child who is not your dependent.
- It is limited to your earned income from the business, so the deduction cannot exceed the net profit from the trade or business the coverage is tied to.
- It is disallowed for any month you (or your spouse) were eligible to participate in a subsidized employer health plan - including a spouse's employer plan - even if you never enrolled.
Because the exact interaction with your return can get technical, this is a "run it past your tax professional" item rather than something to eyeball. But the headline is simple and worth repeating: for most self-employed people, dental and vision premiums are deductible too. For the full picture, see our guide on deducting your Health Insurance premiums when you're self-employed.
Why 2026 makes dental and vision worth a careful look
Budget matters more than usual for self-employed households right now. As of July 2026, the enhanced ACA subsidies that had been lowering marketplace premiums expired at the end of 2025, and the older "subsidy cliff" at 400% of the federal poverty level is back - meaning some self-employed people are paying noticeably more for their medical coverage than they did a year ago. Nationally, KFF estimates that the average premium payment for subsidized marketplace enrollees would more than double for 2026 - climbing from roughly $888 a year in 2025 to about $1,904, a 114% average increase. That is a national estimate, not a North Carolina quote, and it could still change with legislation that was pending as of July 2026 - so it is worth confirming your own numbers when you shop.
What does that have to do with dental and vision? Two things. First, standalone dental and vision are relatively modest add-ons, so they are an affordable way to round out your coverage even in a tighter year. Second, the tax deduction above softens the real cost of every one of those premium dollars. If you are focused on keeping total spend down, it is worth pairing this page with our look at the cheapest Health Insurance options when you're self-employed so you can build the whole stack - medical, dental, and vision - around your budget.
Talk to The Jordan Insurance Agency - free help in Charlotte, NC
You do not have to sort through dental networks, vision allowances, waiting periods, and enrollment timing on your own. The Jordan Insurance Agency is an independent, licensed insurance agency based in Charlotte, North Carolina, and we work with multiple carriers - which means we can compare standalone dental and vision options side by side and match them to the medical coverage you already have or are shopping for.
Working with an independent agent does not cost you more. Agent compensation is a commission the carrier already builds into the policy's filed premium, so the price of a given plan is generally the same whether you buy it through us, through a captive agent, or on your own - the difference is that we can shop several carriers for you instead of being limited to one company's plans. Our help comparing your options is free.
If you are self-employed in the Charlotte area and want dental and vision coverage that fits your budget and your family, reach out to The Jordan Insurance Agency. We will walk you through exactly how to add it, what it covers, and how it fits with your Health Insurance and your taxes.
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