Vision Insurance Plans

Significant coverage for vision care is infrequently included in the typical health insurance policy. Some comprehensive medical plans may offer policyholders a free vision exam every year, but coverage does not commonly extend beyond that unless you opt for special benefits.

Paying out-of-pocket even for common needs like an annual vision check and a prescription for eye glasses or contact lenses can end up costing significantly more than most people expect. In fact, vision insurance policies can save you hundreds if not thousands of dollars in medical vision care if you ever face an eye emergency or need new eyewear. Many vision insurance plans can cost policyholders less than $10 per month in premiums, while more expensive plans offering more extensive coverage are also available. Even better, most people can qualify for some level of coverage with a vision insurance program. Eligibility requirements are mostly concerned with location, whether applicants have other forms of duplicate insurance policies or serious pre-existing eye conditions.

There are multiple types of vision insurance plans available to interested individuals shopping in their state marketplace or through their employer. The average vision insurance policy includes coverage for basic vision care checkups, glasses and contact lens prescriptions, light sensitive lenses and much more. Different levels of coverage can be purchased with most vision plans at varying premiums and with various combinations of deductibles, coinsurance fees and copayments making up a policyholder’s out-of-pocket costs. Some people shopping for a new vision policy may also be interested in learning more about discount vision programs, which provide a set percentage discount on specific vision services for enrollees who see optometrists in the plan’s provider network. Understanding the primary differences between typical vision insurance plans and vision discount plans will help you make an informed decision about which is best suited to your needs. Figuring out what sort of vision insurance plan is right for you depends on your current eye health status and your expected needs in the near future. Read on to learn more about vision insurance plans and how to choose the best one for you.

Vision Insurance Plans Available Today

Choosing a vision insurance policy begins by knowing what sort of vision plans are available to you. One of the most important things to note about vision insurance plans is the differences between them and vision discount plans. Vision discount plans help enrollees save on vision care but are not technically insurance policies for a variety of reasons. Of vision insurance plans, you may be able to choose from an employer-based policy, a rider to an existing medical or dental policy and standalone vision insurance plans. Most people will have at least a few options to choose from of both vision insurance plans and vision discount plans in their area. Here are the primary types of vision care coverage plans that you may find available in your area:

  • Stand Alone Vision Insurance: This is the basic, independent vision plan that is discussed throughout this article. These plans are not connected to any other medical policies, employers or specific groups and usually allow you to easily add dependent family members on to your plan for an additional premium.
  • Vision Insurance as a Rider to Medical or Dental Insurance Policy: Many medical and even dental insurance plans offer policyholders the opportunity to add vision coverage onto their plan for an additional fee, including indemnity insurance policies, health maintenance organizations (HMOs) and for preferred provider organizations (PPOs). In many cases, adding vision coverage to an existing medical policy is the cheapest option available for most people. If you have the option of adding on vision care coverage to your current policy, make sure it is adequate for your needs and affordable.
  • Employer-Based Vision Insurance: Along with medical and dental insurance, some employers offer their workers access to vision coverage. These employer-based insurance plans are often subsidized in the same way as other medical plans and can often be very affordable. If you receive medical insurance from your employer or another similar group, you may also be able to add vision coverage to your existing policy.
  • Vision Discount Plans: Vision discount plans are not insurance policies because they do not actually pay medical providers on your behalf. Instead, vision discount plan administrators make agreements with networks of vision care providers to offer blanket discounts on specific services for program enrollees. With these plans, enrollees pay an annual or monthly premium for access to this network of discounted medical services for which they will cover the costs of any medical care provided completely upfront. Participants in vision discount plans never have to file claims or wonder how much they will be reimbursed for vision care because they pay their entire contribution immediately when services are rendered. On average, vision discount plans cost less in premiums than vision insurance plans but also tend to offer less extensive coverage.

Typical Coverage and Eligibility Criteria for Vision Insurance Plans

Unlike many other types of medical insurance plans, vision plans generally have very flexible eligibility rules for plan applicants. Many vision insurance providers will enroll applicants of any age, including Medicare recipients. Some insurance providers may be curious about your past eye health or issues, but that does not necessarily mean they will deny you for having a pre-existing eye condition. Most standalone vision insurance plans provide coverage for annual eye exams and one pair of reasonably priced prescription eyeglasses and/or contact lenses. Some vision insurance plans include coverage for major eye procedures like LASIK and PRK vision correction, but most do not. Instead, many vision policies will include discounts for these procedures in much the same way that a vision discount plan might.

There are some vision care services that are rarely covered by the typical vision insurance plan. In less comprehensive vision plans, contact lens examinations and prescriptions may not be covered. Eyeglass tinting and light sensitive lenses for glasses are also regular exclusions for vision coverage. Vision therapy services and eye exams or care given while receiving hospital care is not covered in many vision insurance policies. Many vision insurance plans provide for only one pair of eyeglasses a year, even if you need a second pair because the first was lost or stolen. Many insurance providers will allow you to add a rider to your primary vision insurance policy that provides coverage for a situation or issue that would not be otherwise covered by the policy. The cost of these riders depends completely on the coverage requested. Make sure to look at the fine print of any vision insurance policy you are considering to make sure it provides adequate coverage for the vision care services you know you will need.

Average Out-Of-Pocket Costs for Vision Insurance Policies

Many basic vision insurance policies cost just a few dollars a month, especially those that are add-ons to other medical insurance policies you are already enrolled in. Most individual vision insurance plans have premiums that run from about $15 to $75 a month. Because vision services are not as expensive as many other types of medical services, the out-of-pocket costs for policyholders of vision plans are generally lower than they are for many other types of medical insurance policies. This means you usually have to reach a lower deductible threshold before coverage kicks in and make lower copayments or coinsurance payments for most vision services.

There are a few different ways that individuals shopping for vision coverage can save money on their plan. Many employer-based vision insurance plans, for example, can be paid for with funds from a flexible spending account (FSA), health savings account (HSA) or health reimbursement account, which are types of special funds set up to collect a portion of your pre-tax income to go towards your medical bills. Another important aspect of vision insurance coverage and funds that you may stow away towards it is that it does not usually carry over after your policy ends. If you have unused vision plan benefits at the expiration of your policy, you will not be able to take advantage of them at a later date.

How to Choose the Right Vision Insurance Plan for You

When shopping for vision insurance, the first question you need to ask yourself is whether an actual insurance policy is best or if a discount vision plan might better meet your needs. Discount vision plans may be useful if you do not have access to a more comprehensive policy at an affordable price but would still like to save on your basic vision care needs. If you are sifting through various types of vision insurance plans, look at the specific vision services that are included and that are excluded from coverage on the plan. Applicants hoping to take advantage of the benefits of a vision insurance plan immediately after sign up should also make sure that there is no significant waiting period for new policyholders to overcome before full coverage kicks in. If you have a favorite optometrist, make sure she is included in your coverage network or can be seen at an affordable rate through the vision insurance plan you are considering.

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