Whether you’re nearsighted, farsighted or both, you’ve probably experienced sticker shock when paying for an eye exam, new eyeglass frames and lenses, or a year’s supply of contacts. These essentials—and the supplies you need along with them—quickly add up and are rarely covered by standard health insurance plans. In fact, under the Affordable Care Act, only pediatric vision care is a required benefit. And while Medicare Part B covers some vision care (such as screening for diabetic retinopathy, glaucoma and age-related macular degeneration) it does not cover routine vision exams, refractions, eyeglasses or contact lenses.
Fortunately, vision insurance plans are available as part of many employer benefit packages. They can also be purchased directly from insurers by families and individuals who want to save on eye care costs. If you think you might benefit from this supplemental insurance product, consider the following factors when talking to your insurance agent about a vision plan.
There are two different types of vision insurance products.
- Vision benefits packages – These function like health insurance with monthly premiums and copays for annual eye exams, eyeglass frames and lenses and contacts. You may have to meet a deductible before the insurance coverage kicks in. Most of these plans are set up as preferred provider organizations (or PPO). This means you have to choose your eye doctor from a network of professionals who are part of the plan. If you have to go ‘out of network’ for care, you’ll pay a higher percentage of the cost of treatment yourself.
- Discount vision plans – These plans offer a predefined discount on products and services at participating providers. They also require a monthly premium and may require a deductible as well. If you choose to use an eye doctor or eyewear company that does not participate in the discount vision plan, you’ll pay full price for eye exams and products. Discount vision plans typically have lower premiums than vision benefits packages do.
The best vision insurance for you will depend on your needs.
If your vision is good and you really only need an annual eye exam, you’ll probably be better off with a discount vision plan. Vision benefits packages may be better for families who use a lot of eye care services along with vision correction in the form of eyeglasses and contact lenses.
Look at your history when evaluating the cost of coverage.
When decided which type of plan is the best value—or if you’ll benefit from vision insurance at all—you may find it helpful to add up your prior vision care costs. Calculate the total you spent on eye exams and vision correction last year (including lens storage and cleaning supplies if you’re a contact lens wearer). Compare this to the premium plus out of pocket costs you’d expect to pay under each plan for similar products and services.
If you’d like to learn more about vision insurance plans available in your area, we’re here to help. Give us a call today to explore all of your personal insurance options.