While we all understand health insurance is something we shouldn’t live without, many sit on the fence regarding vision insurance plans.
Vision insurance, like dental coverage, is an overlooked aspect of an individual or family health coverage plan. A routine eye exam is essential in identifying and treating problems beyond your eyesight.
Used to supplement health insurance plans, vision insurance can save you money in vision treatment and material costs (frames and lenses) and ensure you catch serious health problems in their early stages, all for a minimal monthly premium.
Why Vision Insurance
Maintaining healthy eyes and one’s vision is an integral part of an individual’s overall health. Without clear eyesight, menial everyday tasks can become monumental. Yet, many people neglect their eyes due to the costs. A vision care plan can alleviate these costs.
- Vision insurance is usually supplemental insurance to other health insurance plans.
- Covers costs related to an eye disorder or if your vision becomes permanently impaired.
- Offset the costs of routine visits to optometrists for check-ups.
- Help to pay for any eyeglass frames/lenses and contacts.
- Coverage for any treatments that may be needed.
My Vision Is Fine… I Think
Even if your vision seems fine, it’s essential to regularly have your eyes checked at least once every other year.
Eye exams have proven beneficial in maintaining overall health, not just detecting vision problems. During your exam, the doctor will evaluate you for serious health problems like – cataracts, glaucoma, and cancer. Even if your vision is 20/20, utilizing your vision insurance to get your eyes checked regularly is a good idea.
What Are the Benefits of Vision Insurance
- Vision wellness – Eye exams are necessary vision wellness checks that are usually covered entirely by vision insurance. Regular check-ups help identify vision correction needs and early stages of eye diseases (glaucoma, cataracts, macular degeneration, etc.).
- Overall health – Eye exams detect serious medical problems as well as eye problems. Catching health issues such as high blood pressure, diabetes, cancers, and autoimmune diseases in their early stages can reduce treatment costs.
- Cost savings – Comprehensive vision insurance plans provide basic coverage (eye exams and frame/lens coverage) plus contributions towards vision correction surgeries and extra prescription glasses.
What Does Vision Insurance Cost
Many employers offer vision insurance at a lower price. However, individual policies can be quite affordable if you do not qualify for a plan through your employer. If you qualify for a group plan through your employer, you may only have a small premium of $3 to $7 per month. If you need a family plan, multiply that price per person.
For an individual plan, the premium will typically be $15 a month for individuals and $50 a month for families, with copays typically costing around $15 per visit.
How Vision Insurance Works
Many vision insurers pay for services received at a clinic of your choice, but it’s best to ensure the policy includes the doctor you want to see before enrolling. If you visit a doctor out of the network, you could pay more out of pocket than your premiums cost you.
Copays and Limits
Vision insurance usually requires a copayment (copay) before receiving a service. This is often a fixed amount, such as $10 for an eye exam.
For glasses and contact lenses, a copay isn’t usually required. Instead, the costs are capped to a certain amount. For example, your vision insurance may pay up to $100 toward frames. If you find a pair of frames you like for $300, you will pay the $200 excess. Plans with higher monthly premiums generally give you better coverage for more expensive frames.
While most plans will at least pay towards standard lenses, only some – usually plans with higher monthly premiums – will pay for lens enhancements (anti-glare, scratch-resistant, etc.).
What Services Are Covered by Vision Insurance Plans
It’s important to know what is included when you come to select a vision insurance plan. The majority of plans cover the following services at the very least:
- Annual eye exams
- Eyeglass frames
- Eyeglass lenses
- Contact lenses
- Discounted rates for laser eye surgery (depending on the plan)
Vision Insurance vs. Vision Discount Plan
A vision discount plan offers flat discounts on vision-related services in exchange for a monthly fee (similar to the monthly vision insurance premiums). You agree to pay the difference for the difference.
Vision insurance includes a network of eye care professionals enrollees can receive coverage, but not all eye care professionals accept discount plans as payment.
What Does Vision Insurance Not Cover?
Vision insurance provides comprehensive coverage for vision check-ups and glasses frames and lenses. However, other eye-related issues are more likely to be covered by medical insurance.
Example, eye-related health issues, covered by medical insurance rather than vision insurance:
- Surgery for medical conditions such as cataracts
- Eye treatments for diabetic retinopathy and macular degeneration
- Medications, like drops for pink eye or glaucoma
- Patches and other therapies to train the eye, as is needed for amblyopia (lazy eye)
What’s Vision Insurance Under the Affordable Care Act?
Under the Affordable Care Act (ACA), all plans on the health insurance Marketplace must offer pediatric vision coverage, including an annual eye exam and some material benefits. This is included for all children, but only providers have adult vision coverage.
Major eye diseases, including glaucoma, cataracts, amblyopia, and age-related macular degeneration, are considered medical problems and, as such, are covered in your ACA health insurance plan. A vision insurance plan will likely be needed if you require adult vision coverage for eye exams, eyeglass frames, lenses, contributions towards laser eye surgery, and more.
Vision Insurance and You
Your choice to purchase vision insurance will ultimately come down to your exact needs. The decision is a no-brainer for most if an employer group plan is available – as the monthly cost is often incredibly cheap.
Individuals who do not qualify for a group program must decide if the monthly premium for vision care coverage is worth the cost. For people over the age of 40, vision care coverage is always recommended. Eyes, like all parts of the human body, require more attention and care as we age.
Vision Insurance Company Reviews
If you want to enroll in a vision insurance plan, hundreds of different providers are available, each with different premiums, coverage levels, and networks of eye care professionals.
Alternatives To Vision Care Insurance
While most individuals and families should strongly consider vision insurance, some people may find the plans unnecessary. If you fall into this group, you can still maintain your eye health without coverage. While important, you can skip out on vision care insurance and usually avoid putting your life in jeopardy or finding yourself bankrupt. The same cannot be said for health insurance. Stores like Walmart and Costco often feature optical centers inside some of their locations. These centers offer eye exams from optometrists and often feature affordably priced glasses and contacts. Ordering glass, frames, prescription lenses and contacts from reputable online dealers often offer significant savings.
Can I Buy Vision Insurance Even Though I Have Health Insurance or Medicare Coverage?
Yes. Your health insurance will likely only cover you for medical eye conditions. But to cover your glasses frames, lenses, or contacts, vision insurance will be required. Similarly, Medicare doesn’t pay for routine vision exams and treatment without a medical condition. Vision insurance can act as a supplement to the coverage you already have in place.
Will Vision Insurance Pay for Any Frames I Want?
Whether your insurer will pay for the glasses frames you want depends on your vision insurance policy. Most vision insurance plans pay for glasses frames up to a specific value, and you pay the difference. Certain lower-cost plans may limit what frames are available.
Does Vision Insurance Replace My Glasses If I Break or Lose Them?
Vision insurance policies generally don’t cover glasses replacement (through breakage or loss), but your provider may include it.
Does Vision Insurance Cover LASIK or PRK?
Laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) are vision correction surgeries. Vision insurance policies often pay for part of LASIK and PRK surgical procedures.