Vision Insurance


Vision Insurance

Many people use the term “Vision Insurance” to describe health and
wellness plans. These plans are designed to reduce costs for routine
preventive eye care and prescription eyewear. However, these vision plans
differ from typical medical health insurance plans. So, what is vision
insurance, and how does it work?

What is Vision Insurance?

Vision insurance is a type of insurance that helps pay for eye care and
eyewear expenses. It is typically a stand-alone policy that differs from
your typical health insurance policy. Vision insurance provides an added
wellness benefit for healthy eye exams, which includes routine eye care,
prescription eyewear, and other vision services at a reduced cost.

Like medical insurance, you pay a monthly premium for vision insurance,
and in exchange, the insurance company agrees to help pay for your routine
vision expenses. Before choosing a vision insurance plan, it’s important
to understand what it covers, what it doesn’t cover, and how much it will
cost.

What Does Vision Insurance Cover?

With vision insurance, you’ll typically have benefits that cover some of
the routine costs for vision care, like routine eye exams, glasses, or
contact lenses. Most vision insurance plans include the following
benefits:

  • Annual eye examinations
  • Eyeglass frames
  • Eyeglass lenses (including lens coatings and enhancements like
    anti-reflective coating and photochromic lenses)
  • Contact lenses
  • Discounted rates for LASIK and PRK (not all vision plans offer this)

When shopping for a vision plan, you’ll find most states have plans
including coverage for both glasses and contacts. Additionally, some
vision plans also offer discounts on elective vision correction surgery,
such as LASIK and PRK.

However, some vision insurance plans do not cover contact lens fittings
(for first-time wearers or established wearers that need to switch to a
new brand) or yearly contact lens evaluations. In addition, vision
insurance plans don’t usually cover the entire cost of corrective
eyeglasses. Some plans only cover part of the cost.

What Vision Insurance Doesn’t Cover

It is important to note that vision insurance plans do not cover medical
eye care. Your regular medical health insurance protects you from
unexpected costs from eye injury or disease.

For example, vision insurance will not cover vision loss, floaters, dry
eyes, allergies, infections, eye disease, or eye exams for complications
from diabetes. If you need medication, the doctor will not be able to
give you a prescription if you are using vision insurance.

Also, vision insurance does not typically cover eye surgery, like
cataract surgery. It will not likely cover treatment for other medical
issues concerning your eyes or vision.

When to Use Medical Insurance for Eye Care

Your medical insurance is usually used if you have an eye problem or eye
disease or if any medical condition is present that causes eye problems.
Some common conditions for which you can bill your medical insurance
include:

  • Patients with vision loss
  • Patients with glaucoma
  • Floaters
  • Dry eyes
  • Allergies
  • Infections
  • Monitoring cataract development
  • Examination of patients diagnosed with diabetes
  • Examination of patients using medications with potential eye side effects,
    such as steroid medications, arthritis medications, etc.

Types of Vision Insurance Plans

Vision benefits plans are standard insurance plans offered through
employers or other groups. A vision benefits plan can also often be
included with preferred provider organizations (PPOs) or health
maintenance organizations (HMOs).

  • Vision PPOs: These plans allow you to visit an in-network provider of
    your choice. They may also provide coverage for out-of-network
    providers. You’ll pay lower out-of-pocket costs when you visit an
    in-network provider, though.
  • Vision HMOs: These plans provide access to in-network eye doctors and
    specialists, but you’ll have to choose a primary care physician to
    coordinate care.

In Conclusion

Vision insurance can be a valuable tool for maintaining your eye health
and managing the costs of routine eye care. By understanding what vision
insurance is, how it works, and what it covers, you can make informed
decisions about your eye care and choose a plan that meets your
individual needs and budget.