Vision insurance can help cover some of the costs of routine eye exams, glasses, and contacts. But is vision insurance really necessary? Here’s what you need to know about it and whether it may be worth it.
What Does Vision Insurance Cover?
Vision insurance plans typically cover some of the following:
Routine Eye Exams Most vision insurance plans cover a yearly eye exam, which allows an eye doctor to check your overall eye health and your need for vision correction.
Eyeglass Lenses Vision insurance can cover all or part of the cost of eyeglass lenses. This includes single vision, bifocal, trifocal or progressive lenses. The plans specify an allowance amount for lenses and you pay any additional costs if you select add-ons like anti-reflective coating.
Eyeglass Frames Plans include a set allowance for frames (usually $100-$200). If you choose frames above the allowance, you pay the difference.
Contact Lenses Instead of glasses, most plans include an allowance for contact lenses that you can put towards contacts. This allowance is usually lower than the frame allowance in most plans.
Contact Lens Fitting If you wear contacts, your plan may cover in full or part of the cost of your contact lens exam and fitting fees.
Discounts on LASIK Surgery Some insurers partner with LASIK facilities to offer plan members discounts of up to 50% or more on procedures. You pay the negotiated discounted price out of pocket.
So in short, vision insurance can cover eye exams plus all or part of eyeglasses or contacts. Keep in mind that plans usually do not cover “extras” like anti-reflective coatings so you would pay those costs out of pocket.
What Vision Insurance Typically Does NOT Cover
It’s also helpful to understand what you will still likely need to pay for out of pocket, with or without vision insurance:
Vision Therapy – Very few vision insurance plans cover specific vision therapy treatments that people with issues like lazy eye may need. These can costs thousands of dollars out of pocket.
Sunglasses – Non-prescription sunglasses are generally not covered. You may be able to use your frame allowance towards prescription sunglasses on some plans.
Eye Surgery – Any surgical procedures are typically not covered, except for discounts that may be offered on LASIK as noted earlier. So procedures like cataract surgery or PRK would need to be paid in full out of pocket.
Excess Costs – If you select extra lens coatings or higher cost frames, you will pay those excess costs beyond what your plan’s allowances cover.
Bottom line, vision insurance can lower the costs of basic vision correction needs for most people like exams, eyeglasses and contacts. But you’ll likely need to pay for anything beyond routine vision care.
Who Needs Vision Insurance?
Trying to decide if vision insurance is worth paying for? Here are some things to consider when evaluating if vision insurance makes sense for your situation:
You Wear Prescription Glasses or Contacts
If you wear prescription eyeglasses or contacts, having insurance to help cover replacement glasses or contacts every year or two can significantly lower your own out-of-pocket costs.
For example, say an eye exam is $100, frames average $200, and lenses are $100 or more. Just paying for one set of single vision glasses and an exam could be $400 or more out of pocket! Having insurance can cut those routine costs in half or cover them entirely depending on the plan.
You Have Children Who Need Vision Correction
Kids grow rapidly, meaning they often need new glasses every year or two. Without insurance, paying $200, $300 or more out of pocket each time can really add up. Vision insurance allows kids to get updated eyeglasses regularly at a reduced cost.
You Develop Vision Issues Like Cataracts Later On
As we age, vision problems become increasingly more common. From presbyopia diminishing close-up vision to developing cloudy cataracts, seniors have some of highest rates of vision impairment.
Having insurance can allow you to access the vision care you need as you get older without high out-of-pocket costs.
You Have Specific Eye Conditions
For those diagnosed with specific eye diseases like glaucoma or at higher risk for conditions like macular degeneration, having insurance coverage for at least yearly eye exams can be critical to monitor eye health.
This allows eye doctors to catch and treat issues early before they progress.
When Vision Insurance May NOT Be Necessary
Of course, vision insurance isn’t necessarily a smart financial move for everyone either. Here are some instances when it may not provide enough value:
You Have Great Natural Vision – If you have almost perfect vision without need for glasses or contacts, a vision plan that mostly covers eyeglasses likely won’t benefit you much. Just paying the $100 or so for an annual eye exam out of pocket instead can make more sense.
Your Plan Has Limited Providers – Some vision plans restrict which eye doctors and facilities you can use or charge higher costs for going out of network. If the plan limitations will hinder you from seeing the eye doctor you want, it may not be worth paying for that plan.
You Already Have Eye Health Concerns – For those dealing with specific eye diseases like cataracts or glaucoma that require regular specialist care and procedures beyond basic vision correction, vision insurance likely won’t cover or discount those costs. Having comprehensive health insurance would be more beneficial.
It’s Offered As A Work Benefit You Won’t Use – Many employers today offer voluntary vision plans. But if premiums will just come out of your paycheck without you really benefiting from the coverage, it can become one more unnecessary expense.
Getting down to where vision insurance does and doesn’t make sense can help you evaluate if paying those premiums will be worthwhile for your personal eye care needs.
Factors that Affect Vision Insurance Cost?
Some factors impacting your specific vision insurance premiums can include:
Who’s Covered – Plans covering just you individually usually cost less than family plans covering a spouse and/or children as well.
Your Location – Insurance rates for the same plan can be higher depending on where you live. Vision costs tend to be lower in more rural vs. urban areas.
Your Age – Premiums may be lower for younger participants. Standard rates often apply up until about age 40, then increase for older policyholders.
Pre-Existing Conditions – Some medical eye conditions diagnosed before purchasing insurance could affect premium costs.
Plan Type – Mini plans only covering eye exams and glasses or contacts tend to cost less than more comprehensive plans.
To find tailored quotes with accurate pricing for your situation, it’s best to check with specific vision insurance providers directly.
When budgeting for vision insurance, expect to invest anywhere from a couple hundred dollars to $500+ per year depending on your coverage selections.
Should You Buy Standalone or Comprehensive Vision Insurance?
You can purchase vision insurance in a couple different ways – as a standalone policy only covering vision costs, or as part of comprehensive health insurance covering both medical and vision expenses.
Your option might be better depends on your specific needs and situation.
Standalone Vision Insurance
Purchasing a targeted vision insurance policy by itself allows you to hand pick coverage focused specifically on routine eye care expenses like exams, glasses and contacts. These more affordable standalone vision plans can make sense if you:
- Already have general health insurance but it lacks vision benefits
- Don’t require frequent medical care but want extra vision coverage
- Are primarily concerned about covering basic eyeglasses or contacts costs
Just keep in mind limitations. Standalone vision plans tend to cap annual benefits and won’t cover medical eye treatment costs should you develop a condition like glaucoma or cataracts.
Comprehensive Health Insurance
Alternatively, buying into a comprehensive major medical insurance plan can offer coverage for both general healthcare AND vision costs, which may be the better route if:
- You don’t currently have insurance protecting against unexpected medical expenses
- You have specific eye diseases like glaucoma or diabetes impacting vision
- You want one insurance plan covering medical, vision, dental, etc. without gaps
Comprehensive plans provide more robust coverage but note premiums and deductibles will be higher given all that’s included. Also double check details as some health plans still lack vision coverage.
Choosing between standalone vision insurance or a comprehensive medical plan can take some thoughtful analysis around your healthcare priorities. Involve an insurance agent or advisor to ensure you select coverage meeting both your eye care and overall health needs at a workable cost.
Top Vision Insurance Providers to Consider
If you’ve determined vision insurance makes sense for your situation, deciding on a reputable insurance provider is key. Here are a few top insurers providing coverage for routine eye care and vision costs:
VSP Vision Care
VSP Vision Care offers both employer and individual/family vision plans accepted at a large network of eye doctors across retail chains like Costco Optical and private optometry practices.
Highlights:
- Discounts on eyeglass lenses, frames, and contacts
- Extra savings like an extra $20 to spend on featured frames
- Out-of-network reimbursements up to $50 for exam and $70 for glasses
Consider If: You want a larger national vision network with flexibility to see who you want.
EyeMed
Part of the Wellpoint network, EyeMed contracts with popular retailers like LensCrafters, Target Optical, Sears Optical and JCPenney Optical to provide vision insurance good at thousands of in-store locations.
Highlights
- Access discounted exams and eyewear at huge retail chain network
- Mix and match benefits for glasses and/or contacts
- App to manage claims, find providers and order contacts
Consider If: Discounted glasses and contacts from major retail brands appeals to you.
Humana
Insurance giant Humana offers both stand-alone vision policies and vision coverage under comprehensive medical plans for groups and individuals.
Highlights:
- National network of independent eye doctors and optical retail locations
- Option for fully insured group plans and self-funded plans
- Medical members can add vision rider to integrated benefits
Consider If: You prefer working with a large insurer like Humana and want to bundle medical.
MetLife
Known for dental insurance, MetLife also provides group and individual vision insurance options under the MetLife Vision brand.
Highlights:
- Discounts and contracted fixed pricing for eye exams, glasses and contacts
- Covered lens options include polycarbonate and scratch-resistant
- Additional lens add-ons at set discounted pricing
Consider If: Having fixed copays and set discounted pricing appeals to you.
UnitedHealthcare
As another leading medical insurer, UnitedHealthcare also offers employer and personal vision coverage with the UnitedHealthcare Vision plan.
Highlights:
- Access routine and follow-up eye exams along with glasses/contacts
- Retail chains like Walmart, Sam’s Club and Costco in network
- Buy up option for higher lens allowances and frame discounts
Consider If: You prefer sticking with a top name in health insurance.
This sampling of top insurers provide options whether you want national access, retail chain convenience, discounted pricing, or integrated medical-vision benefits. Compare plans side by side when choosing vision coverage right for your eyes and budget needs.
Is Vision Insurance Worth the Investment?
At the end of the day, is securing vision insurance worth paying those monthly premiums? In many cases, vision insurance can be valued protection against having to cover hundreds of dollars in routine eye exam and vision correction costs entirely out of pocket later on.
Paying $100 to $300 yearly for insurance that keeps another $200, $300 or more per year in your wallet makes solid financial sense for glasses and contact lens wearers.
But vision insurance may provide less payoff if you have no current need for vision correction, limited choices in providers or plans trying to skimp on necessary eye care coverage.
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