Health insurance can be challenging to understand. Eye care plans are no exception. There are many different coverage types, and it can be hard to know which is right for you.
We’ve put together the following information to help you understand vision insurance plans. Read to find out all you need to know about these policies.
What is Vision Insurance?
Vision insurance refers to health plans that help you pay for eye exams, glasses, and contact lenses. In some cases, vision benefits may be part of a broader health coverage your company provides. You may also purchase this separately if your traditional medical plan does not include it.
Most vision insurance plans do not provide comprehensive coverage. Instead, they give discounts for specific products or services. For example, while some may cover the full cost of eyeglasses or contact lenses, others may provide only a partial amount.
Since eye care insurance benefits vary greatly, be sure you understand the plan you’re considering. Ask your insurance provider to explain each policy’s costs and benefits before you make your decision.
When you visit your optometrist, you can also ask the staff to remind you what your plan covers. In this way, exams and eyewear costs will not surprise you.
Who Sells Vision Insurance?
In many cases, eye care plans come with health coverage through a group policy. You may already have vision insurance through your workplace, association, Medicare, or Medicaid.
In other situations, you can purchase this coverage separately. You may need an individual plan if you:
- Have a group plan that does not include vision care
- Are self-employed
- Do not qualify for group coverage for another reason
You can obtain eye care insurance through the same providers that sell traditional health plans. These include:
- Indemnity insurance providers – allow you to choose your medical providers.
- HMOs – usually permit access to only a specific group of healthcare professionals.
- PPOs – provide lower-cost health services when using preferred providers. The services are typically more expensive if you choose a doctor outside the network.
Purchasing vision insurance will give you discounts on eye exams, glasses, and contacts. You’ll also gain access to a network of providers, including:
- Eyewear stores
- Optical laboratories
- Eye surgeons
What Plans Are Available?
There are two types of eye care plans. They are the discount plan and the vision benefits package.
A discount vision plan requires an annual membership fee or premium. Once you pay that amount, you can access lower prices for eye exams, glasses, and contact lenses.
A vision benefits package similarly charges an annual premium or membership fee, but often includes a copay. Some services or products may have no additional charge, while others require payment of a fraction of the full cost.
Both types of plans may include a deductible, a fixed amount you must pay for eye care before the benefits take effect. Policies typically include coverage or discounts for the following services and products:
- Yearly eye exams
- Eyeglass frames and lenses
- Specialized lens coatings and enhancements for eyeglass lenses
- Contact lenses
More comprehensive plans can provide coverage for expenses related to eye diseases or permanent vision loss. You may want to consider this type of policy if you have one of the following conditions:
- Diabetic retinopathy
- Retinal detachment
- Retinitis pigmentosa
- Macular degeneration
If you have a health insurance plan, you may already hold coverage for the above conditions. Be sure to check your existing policy before purchasing an additional one for these specific purposes.
Some policies also provide discounts on vision correction surgery like PRK and LASIK. However, this is not a standard feature of all plans, as these procedures are generally considered elective, not an emergency.
Because of the vast range of coverage available, it is critical to compare plans before purchasing. Doing so will help ensure you find the policy with the right services.
Will Vision Insurance Save Me Money?
If you rarely have eye care expenses, you may not need insurance in this area. You may choose to take advantage of low prices at large vision care centers if you only occasionally need these services. However, if you have these kinds of expenses every year, a vision plan is likely to save you money.
You can be sure of your savings before purchasing by adding up your yearly vision expenses. Then, research what you would spend on the same items with your proposed eye care plan. Be sure to include the amount of any premiums or copays.
If the total amount you’d pay out of pocket is less with the vision plan, it’s likely a good deal. By comparing these amounts at several insurance companies, you can choose the best value for the benefits you need.
Vision insurance includes plans that offer discount and wellness options for products and services related to eye health. If you do not already have group eye care coverage, you can purchase one through traditional insurance companies.
Plans usually include discounts for eye exams, glasses (including specialized lenses), and contact lenses. Some policies may also provide lower prices for elective eye surgery. Shop various insurance providers to help you choose the coverage that will save you the most money.