It might seem like vision insurance shouldn’t be a separate thing from health insurance (you might feel this way about dental, too), but the fact is that most health insurance providers require an additional plan to cover vision.
Vision insurance is designed to reduce or eliminate out-of-pocket costs for eye exams and other preventive measures. It can also be used to pay for glasses (both the frames and lenses) or contacts to correct vision problems.
So, what does a vision plan cover? Think of it as getting a series of coupons for various aspects of your visual health. For the vast majority of plans, you’ll still have to pay a specific amount for your services, but the insurance gives you a discount.
Depending on the quality of your plan and how much you pay in, you might even pay less for more luxurious add-ons (AKA what most insurance would probably deem unnecessary) like progressive or transition lenses. Your vision insurance will also cover or discount treatments for eye diseases and injuries.
Does Health Insurance Cover Vision?
If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or some sort of injury, then your regular health insurance will more than likely cover you.
But that’s the difference. The eye issue is a medical problem at that point, not a vision correction issue. Vision problems don’t always result in adverse health effects on their own.
For instance, if your eye doctor was fitting you for contact lenses and discovered a serious medical issue, your regular health insurance would cover further exams and visits until the problem was resolved.
This is also where you should be aware of the difference between optometrists and ophthalmologists. Optometrists take care of vision exams, fittings for glasses and contacts, and detect possible eye concerns. However, they are not medical doctors.
Ophthalmologists are medical doctors. If you need to see an ophthalmologist, it’s not for standard vision insurance issues; it’s for something more serious, such as eye surgery or disease treatment.
Does Vision Insurance Cover Contacts?
Very few plans fail to offer a discount for contact lenses. But, that doesn’t mean that contacts will necessarily be as cheap as glasses.
Your eye doctor may need to perform tests to make sure you can even wear contacts, and you’ll probably end up getting a spare pair of glasses in case you run out of contacts, lose them, or get an eye infection.
Not everyone can wear contacts (or at least it takes a lot more effort for some people). Dry eyes, allergies, and frequent eye infections can make contacts a difficult proposition.
Does Vision Insurance Cover Lasik?
Insurance companies, including Medicare and Medicaid, usually consider Lasik to be a cosmetic procedure, since glasses and contacts will help you to see at considerably less expense. Medicare Advantage is a “maybe,” depending on which plan you have.
With that being said, some plans do cover Lasik, and many providers offer large discounts on the procedure. Some plans can even reduce the price by 50%.
Another way your vision insurance can help you pay for Lasik is when you use a Health Savings Account or Flexible Spending Account, which lets you save money for medical procedures (Lasik included) completely untaxed.
These untaxed funds also come in handy for items that are not usually covered by insurance, including prescription sunglasses.
How Expensive is Vision Insurance?
Vision insurance is usually between $7 and $30 extra per month on top of your existing insurance. Since eye exams can cost upwards of $250, it’s probably worth it for you to buy insurance!
Shopping around is the way to find the best price if you decide on private health insurance like VSP, EyeMed, or Humana. If you’d prefer Medicare or Medicaid and you qualify, generally, you’ll find that the cost is pretty low.
Some plans include deductibles, an amount you pay before insurance jumps in and pays the rest. Copays, or the fixed dollar amount you pay for using vision services, can also vary. These differences can be due to the state you live in and which types of vision services you require.
Do I Need Vision Insurance?
Now, we’ve reached the most complicated question of all. Do you need vision insurance? It depends on your family history, current eye health, the likelihood of injury, age, and other risk factors.
If you’re between 20 and 39, you can often go five years between eye exams. Once you’re 65, you’ll need to schedule them as often as every year.
If you’re in good shape financially and have fantastic vision, you might be able to pay out of pocket for your eye exams. If not, then you’ll probably be happy that you have the insurance in place to reduce more frequent costs.