Health Insurance for Vision
Vision insurance provides coverage for services provided by eye-care professionals such as ophthalmologists and optometrists. It is important to note that vision care is a “wellness” benefit.
While proper preventative eye-care is critical, insurance to cover it can either be part of a larger insurance plan or a separate, optional policy.
While every plan is different, most plans include coverage for certain services: eye examinations, frames, lenses, contact lenses, prescription lenses and special procedures such as laser eye surgery.
Types of Vision Insurance Plans
In terms of costs there are two basic types of vision insurance plans: discount and premium.
In a discount plan, you will have access to a network of providers that have agreed to render services at fixed, discounted prices. When you have a premium plan, you pay a fee to be a member and you generally have to pay a “deductible” amount out of your own pocket before the policy begins to pay and “copays” of a small amount of out-of-pocket money to the doctor at the beginning of each office visit. Typical deductibles in a premium plan are $50-$100 and co-pays will cost from $10-$25.
The plan may further be set up as a health maintenance organization (HMO), a preferred provider organization (PPO) or a traditional indemnity insurance plan. HMO's require you to visit a provider in their network. PPOs may offer the option of using a provider not in their network, but the insured will be responsible for the additional cost.
Other factors to consider when choosing a plan include:
- Proximity to home or work
- Hours during which the providers see patients
- Quality of care and level of services offered
If you want vision insurance and your employer doesn't offer a vision care plan, there are several national companies that offer vision insurance. You will find they vary considerably in the level of service they provide and the cost, so a careful analysis is a good idea:
Spectera, Inc.
Columbia, Maryland
1-800-638-3120
Vision Plan of America
Los Angeles, California
www.visionplanofamerica.com
800-400-4VPA
VSP
Rancho Cordova, California
1-800-897-7195
While benefits will differ form plan to plan, here is a sample plan and the levels of coverage it provides:
Benefit Year: 1/1/ through 12/31
|
Service |
Type |
Quantity |
Period |
Benefit |
|
Exams |
Regular Vision |
One |
One benefit period |
$50.00 |
|
Frames |
Regular Frames |
One |
Two benefit periods |
$75.00 |
|
Lenses |
Single-vision |
One Pair |
One benefit period |
$50.00 |
|
|
Bifocals |
One Pair |
One benefit period |
$60.00 |
|
|
Trifocals |
One Pair |
One benefit period |
$75.00 |
|
Contact Lenses |
Medically necessary |
One Pair |
One benefit period |
$125.00 |
|
|
Cosmetic |
One Pair |
One benefit period |
$75.00 |
Summary
As with all insurances, there will be a great deal of fine print. Check with a trusted financial adviser or insurance agent to see which plans makes the most sense for you and which companies will have the financial strength to meet their coverage obligations.