What is Vision Insurance?
Vision insurance generally refers to wellness plans established to help policyholders lower their out-of-pocket cost for preventive and routine eye care, eyeglasses, contact lenses and other eye-related treatments. Some policies may even cover corrective surgeries and procedures such as photo-refractive keratectomy (PRK) and LASIK. However, vision insurance doesn’t work the same way as traditional medical insurance, which offers unlimited benefits after meeting deductibles and copays.
Rather, most vision plans work as discount plans with set limits and benefits in exchange for an annual premium. Vision insurance covers much of the cost of comprehensive eye examinations, eyewear, and contact lenses, with policyholders paying a small co-pay and or meeting a deductible prior to benefits kicking in. Most policies require add-ons to cover enhancements such as scratch-resistant coatings, photochromic lenses, progressive lenses and anti-reflective coatings.
What Does Vision Insurance Cover?
Every vision insurance provider will offer different levels of coverage amid their range of policies and add-on options. However, the primary services and enhancement options are typically the same across the board. Traditionally, one can expect a good vision insurance policy to offer the following benefits.
- Eye Examinations: Policyholders will qualify for one annual vision exam, with co-pays ranging between $10-$20.
- Eyeglass Frames: Often offered in the form of an ‘allowance,’ which is how much the insurer will pay, eyeglass frame discounts range between $125-$150 depending on the provider.
- Lenses for Eyewear: Typically, out-of-pocket costs for standard lenses are a co-pay ranging between $20-$30, with benefits available once annually.
- Contact Lenses: Payouts for contacts average between $100 and $150, depending on the level of coverage and policy limitations.
- LASIK and Surgical Procedures: Many providers will offer some type of discount or coverage for vision correction surgeries. The amounts will vary, but they average around $500 max payout.
Common enhancements or add-ons to vision policies allow benefits for transition lenses, progressive lenses, polycarbonate lenses, scratch-resistant coatings, etc.
What Does Vision Insurance NOT Cover
As with any type of insurance policy, there will be exclusions concerning what the company will and will not cover. Vision insurance is no different, and exclusions will vary from provider to provider. However, vision insurance coverage typically excludes:
- Exams beyond one per year.
- Eyeglass replacements w/o warranty insurance.
- Charges for missed appointments.
- Provider application fees or miscellaneous charges.
- Reading glasses or magnification devices.
- Experimental procedures.
- Medically related eye problems that should be covered under a health policy.
How Much Does Vision Insurance Cost?
How much vision insurance costs will depend on a number of factors, including whether the coverage is employer-provided and whether it is bundled with a larger policy such as health and dental. Other factors, such as where the applicant lives, their age, the level of coverage requested, etc., will also play a role in determining the final cost of a vision insurance premium.
Seniors who are still covered under an employer-sponsored plan may have the option to participate in a flexible spending account for vision care. Another affordable option for seniors is to purchase a Vision Service Plan (VSP). The best advice here is to shop around or use a search company that will ease the process of getting matched up with the best carrier within your budget.
Why is Vision Insurance a Good Investment for Seniors?
Vision insurance is a wise investment for most seniors, as age tends to bring about weaker vision and can foster a number of age-related eye conditions, such as macular degeneration, glaucoma, cataracts and dry eyes, to name a few. It is recommended that seniors over the age of 64 receive a comprehensive eye examination once a year, according to the American Optometric Organization. However, those with an eye-related condition or really poor vision will want to come in twice per year.
The nonprofit organization FAIR Health states that an eye exam’s cost ranges between $128-$200, and the average co-pay for examinations is around $20 per visit. With a fairly priced policy, the cost of one eye exam can easily recompense expenses on policy premiums. Seniors who require corrective lenses or who manage an eye-related condition with an optometrist will benefit most financially from having vision insurance. Vision policies have a set allowance for such needs, so customers will spend less out of pocket when getting new contact lenses or eyeglasses.
Whether or not vision insurance is worth the expense is a personal choice, but if you have vision problems, you’ll likely get your money’s worth with coverage.