In this article, we’ll explain what vision insurance is, how it works, how much it costs, and all the other things you need to know about vision insurance. Ensure you carefully read through.
What Is Vision Insurance?
Routine eye health expenses such as eye exams, contact lens fits, contact lenses, and eyeglass lenses and frames are covered by vision care insurance.
A vision care plan may cover the entire cost of routine eye care or require the policyholder to pay a flat fee or a portion of the cost in order to split the cost with the insurer.
The term “vision insurance” refers to health and wellness plans that help you save money on routine preventive eye care (eye exams) and prescription eyewear (eyeglasses and contact lenses).
Unlike major medical insurance policies that provide endless benefits after certain co-pays and deductibles are met, these insurance plans are discount plans or wellness benefit plans that render specific benefits and discounts for an annual premium.
How Does Vision Insurance Work?
For vision coverage, you are expected to pay a premium or membership fee. Then, when you visit your eye doctor or buy corrective lenses, you pay a reduced amount for services.
Corrective lenses are frequently reimbursed by a copay or a yearly maximum amount. If you’ve set a budget, you’ll only have to pay if your eyeglasses cost more than that.
For instance, if your insurance covers eyeglass frames up to $120 and the frames cost $160, you would only have to pay the $40 difference.
Other procedures, such as eye surgery or disease treatment, are frequently reimbursed at a reduced cost.
The majority of policies will have restrictions on eyeglasses coverage. A plan might, for example, include a new pair of eyeglass lenses every year, eyeglass frames every two years, and contact lenses every year.
During a plan year, many plans will limit coverage to either eyeglasses or contact lenses. Because plans differ, be sure to read your benefits information carefully.
Why You Need Vision Insurance
One of the greatest benefits of vision insurance is it covers or cuts the cost of eye exams and medical eye care. Some plans also save you money on eyeglasses, contact lenses, and even vision correction surgery like LASIK.
In fact, how much this will save you depends on your particular plan.
According to Gallup, approximately 90 percent of adult Americans report wearing some type of corrective lenses. A visit with your eye doctor can determine whether you need corrective lenses and, if so, the correct prescription.
Regular eye exams also identify overall health concerns, such as diabetes, high cholesterol, and risk of heart disease or stroke before you are even aware of any symptoms.
You can then follow up with a medical doctor, minimizing the effects of these conditions on your health and finances.
With vision insurance, you can choose between Basic and Plus Plan options, both of which use the Vision Service Plan (VSP) Choice Network but offer different levels of benefit coverage.
In a few lines to come, we’ll talk about what is covered under this insurance.
What is Covered Under Vision Insurance?
Vision insurance provides coverage for basic care and eyewear.
See the list of services covered under this insurance:
- Annual or biannual eye exams, including dilation
- Eyeglass frames
- Eyeglass lenses
- Contact lenses
Some plans may also cover other services, including laser vision care programs or even prescription protective eyewear that complies with ANSI and OSHA safety guidelines.
Vision plans generally do not cover replacements for frames, eyeglass lenses or contact lenses, medical or surgical treatment, vision training, or experimental vision services or treatments.
How Much Does Vision Insurance Cost?
If your employer does not provide vision insurance, you may be able to find coverage for less than $20 per month elsewhere.
According to each insurer’s website, Humana offers vision insurance plans starting around $16 to $18 per month, and VSP offers policies starting at less than $17 per month per person.
In addition to a monthly premium, you’ll likely pay a certain amount that covers costs for visits, exams, and glasses or contacts. Ideally, the higher your monthly premium, the less you’ll have to pay out of pocket for these services.
The benefits of VSP plans differ from one plan to the next. Most plans also cover the cost of contact lenses, which can be used instead of or in addition to glasses, depending on the plan.
Visit vsp.com or chat with your HR person at work for further information and specifics regarding your individual VSP benefits (if covered).
What Kind Of Vision Insurance Plans Are Available?
Vision insurance plans offer either a vision benefits package or discounts on eye care and eyewear.
A vision benefits package covers services such as eye exams that may demand co-payment from you at the time of service, with the balance to be paid by your plan.
In a vision discount plan, you are expected to pay fully for services but at a lower-than-normal price that the plan’s participating eye care practitioners have agreed to charge members.
Let’s take a look at the two types of vision insurance plans:
1. Vision Benefits Package
This type of insurance is frequently purchased in addition to traditional employer-provided healthcare. This includes a set of benefits related to eye health and maintenance, such as routine eye exams and testing, discounts for corrective eyewear, and even benefits that lower the cost of eye surgery.
This type of vision insurance usually comprises a network of participating eyecare practitioners who have agreed to abide by the plan’s terms.
This sort of vision insurance plan has evolved over time to include a more personalized choice for the consumer in the form of defined contribution vision coverage, which allows you.
The consumer, to pick and choose whatever services and discounts you want depending on your anticipated vision expenses.
Many of these vision plans need pre-tax monies to be deducted automatically by your employer through Flexible Spending Accounts, “Cafeteria” Plans, Health Savings Accounts, or Health Reimbursement Accounts.
Each has its own set of tax benefits and cons, which you should examine in detail with your vision plan administrator or provider, as well as a tax specialist if necessary.
2. Vision Discount Plans
This type of vision insurance is generally less flexible than a vision benefits package because it offers flat discounts across the board for a wide menu of vision-related services, like specified discounts on eye exams, eyeglasses, and contact lenses, even many surgical procedures.
You agree to pay the difference in cost in full—however, these types of plans usually offer lower premiums than traditional vision benefit plans.
This type of insurance plan includes a “network” of participating eyecare professionals who have agreed to honor the stated discounts within the vision plan, so long as you agree to pay the difference.
Where Can I Get Vision Insurance
Vision insurance is a value-added benefit linked to indemnity health insurance, health maintenance organizations (HMOs), and preferred provider organizations (PPOs) that have contracted with managed vision care networks to provide eye care services.
Indemnity health insurance is traditional health insurance that allows policyholders access to medical providers of their choice.
There are two main ways to get vision insurance: You can either go individually or through your employer (a group plan).
Group vision insurance can be obtained through your company, association, school district, etc., or through a government program such as Medicare or Medicaid.
If you are not eligible for a group plan because you are self-employed or for other reasons, most vision insurance providers also offer policies that you can purchase individually.
An HMO is a group of healthcare providers — doctors, laboratories, hospitals, and the like — employed to provide healthcare to plan members at discounted rates. Plan members are often required to use only HMO providers for health care (including vision care).
A PPO is a group of healthcare providers who have banded together to provide healthcare services to health plan members at a discounted rate. Out-of-network providers are available to plan subscribers, but they normally come at a higher cost.
When you buy vision insurance, you receive the following benefits:
Access to a network of providers, including optometrists and ophthalmologists, eyewear stores, optical laboratories, and LASIK surgeons
Routine, preventive eye care services at reduced rates
Pros and Cons of Vision Insurance
Vision insurance has advantages and disadvantages, and whether or not you should acquire it depends on how much you need it. It may be worth the extra money to obtain this insurance if you have a history of eye-related medical problems.
If you just visit the eye doctor once a year for normal check-ups, an expensive eye care insurance plan may not be essential.
Overall, vision care insurance is not expensive, and it may save you money in the long run, especially if you have recurring eye problems or need to buy corrective lenses on a frequent basis.
It can also help with the cost of eye surgery if you need it.
Let’s take a close look at the pros and cons of vision insurance:
- These can often be easily added to insurance plans.
- You can also buy a plan individually.
- Premiums are not expensive.
- The plans offset the cost of corrective lenses.
- You may not be able to use out-of-network services.
- If you don’t need regular eye care, it may not be worth the money.
- Some vision care insurance limits what you can purchase in terms of eyewear.
See also: Who Is An Independent Insurance Agent?
Are There Alternatives To Vision insurance
It’s fine to forgo vision insurance if it sounds too complicated, you don’t think you need it, or you’re not sure if it will pay off.
Unlike health insurance, ignoring vision insurance is unlikely to land you in bankruptcy court or jeopardize your life.
There are a few options for getting low-cost vision treatment without having to get vision insurance. Costco and Walmart, for example, feature optical centers in some of their locations.
Exams are performed by professional optometrists, and glasses and contacts are sold at a reasonable price.
FAQs On Vision Insurance
Vision insurance and vision benefits plans typically cover the cost of an annual eye exam and prescription eyeglasses and/or contact lenses.
It depends on your plan but you may pay as little as $5 a month for a basic plan from your employer or buy a plan directly from a provider. For example, VSP Vision insurance offers a $13 a month premium.
According to the Vision Therapy Institute, when insurance covers some of the costs for vision therapy, it is covered by health insurance, not vision insurance.
Vision insurance plans offer either a vision benefits package or discounts on eye care and eyewear.
Your eyes are critical to your everyday life beyond your vision. Therefore, taking steps to promote your eye health and safety by obtaining vision insurance can deter specific eye diseases and injuries.