While more Americans have gained access to affordable health insurance through the Affordable Care Act, vision insurance plans have not achieved the same amount of traction. Having vision insurance can help reduce your out-of-pocket expenses for vision-related care. These services are commonly not included in standard health insurance plans and may or may not be offered by employers.
However, Americans have the option of purchasing private vision insurance plans, should they choose to.
Over 150 million Americans currently use some form of corrective eyewear to compensate for low vision or other eye conditions. Corrective lenses are especially common in older adults, seniors, and people with medical conditions that impact eyesight, such as diabetes. Vision insurance can be vital for these individuals and can ensure that they can afford routine vision exams, corrective eyewear, and other services.
Learn tips for choosing the right vision insurance plan by reviewing the sections that have been provided below.
Types of Vision Insurance Plans
Before reviewing vision insurance plan (VIP) providers and exploring your coverage options, it’s essential to understand the types of plans available to you.
Some health insurance plans provide vision-related coverage and services. Others may include the option of tacking on these benefits for an additional charge. Like dental insurance, these add-on options can help provide you and your family with additional coverage and benefits.
You can also purchase a private vision service plan, also referred to as stand-alone vision insurance. With this form of insurance, you choose a provider for your insurance, and it is separate from any other type of health insurance you have. Stand-alone insurance plans are not sold on the Health Insurance Marketplace, so you will need to apply for insurance directly through a provider.
Exploring Vision Coverage Options
Each vision insurance plan may include different coverage options. However, many plans provide at least some form of coverage for basic services such as:
- Annual vision examinations
- Corrective lenses and frames
- Corrective contact lenses
- Discounts on vision correction procedures, such as LASIK or PRK
Plans will include limits on how often you can receive certain coverage. For example, a vision insurance plan may restrict coverage on corrective lenses annually or once every two years. Plans may also limit lens or frame brands or allow a specified allowance towards additional features, such as transition lenses or anti-glare features.
If you have a progressive vision condition or medical disorder, you may need more frequent eye examinations or other treatment options. It’s essential to keep your conditions in mind when exploring and comparing VIP providers to help you find the best plan for you.
Breaking Down the Cost of Vision Insurance
When comparing vision insurance plans, it’s worth taking the time to break down the costs of each plan. This can help you make sure that you are selecting the right plan for your budget. On average, you can expect to pay between $10 and $30 each month for your vision insurance.
When reviewing the cost of a plan, keep in mind the following expenses that you may face.
- Premiums – Your premium is an amount that you pay in regular intervals (i.e. monthly) to maintain your insurance plan. In many cases, premiums are the highest fee that you will incur as part of your insurance, outside of any non-covered, out-of-pocket expenses.
- Deductibles – A deductible is an amount you must pay out-of-pocket before your insurance plan begins to help cover the cost of your vision care. Not all insurance plans include a deductible, but many do. The deductible amount varies by the insurance provider, and this amount must be met within the calendar year.
- Copayments – Copayments are smaller fees that are charged at the time you receive specific services. These payments are made directly to the vision care office that serves you.
- Coinsurance – Once you have met your deductible for the year, your vision insurance plan will begin to pay a portion of the expenses incurred from covered services. However, the plan may not cover 100 percent of those costs. Coinsurance is the portion of the bill you are responsible for after your insurer has paid their part.
- Enrollment fees – Some VIP providers may include an enrollment fee or other charge when you first enroll in coverage. Some providers may charge this fee on an annual basis. Before applying for insurance coverage, it’s worth taking the time to ask about any additional costs, such as enrollment fees, that you may be expected to pay.
- Out-of-pocket expenses – When choosing a vision insurance plan, also consider out-of-pocket expenses that you will incur for items and services not included in your plan. These out-of-pocket expenses will help you determine if a specific insurance plan is worth the cost you will pay.
Other Factors to Consider When Exploring Eye Insurance Options
To choose the best vision insurance plan for you, it’s important to consider a few other factors when selecting a plan or provider. Be sure to ask yourself these questions:
- Do you need insurance for yourself and/or your family? Family plans typically cost more since they provide additional coverage, but insurance may reduce the out-of-pocket expenses that you would otherwise face.
- How much would plan expenses set you back vs. if you went fully out of pocket? Break down the costs associated with a plan and compare those costs to the amount you would otherwise pay out-of-pocket for the vision services you may receive. If you’d be paying a lot more for one option than the other, this can be a clear indicator of which option is the right way to go.
- Does your current preferred eye doctor accept the insurance you are considering? Like health insurance, many vision insurance plans include in-network and out-of-network providers. If you have a routine doctor that you see for your vision care, ensure that they and their practice are included in a plan before you enroll. Otherwise, you may still pay more in out-of-pocket expenses or be forced to choose a new vision service provider.