Patient Education

Vision Insurance Plans

To fully understand to role of vision insurance plans, consumers should realize that the majority of vision insurances are designed to be additional wellness options, covering preventive measures and common cost including eye exams with dilation, prescription lenses, frames, contact lenses, and other discounts. Most vision insurances do not cover surgery or medication, as this is often covered by regular health insurance, and is why vision is often offered as a secondary option along with dental for health plans. Elective procedures like LASIK eye surgery and PRK are not generally covered by basic vision insurance. Vision insurance can also be purchased outside regular channels through independent companies which offer it. There are three main categories for vision service plans, and all have different options including co-pays, in-network selections, and other costs.

The first is your regular vision insurance plan that covers eye exams, prescriptions lenses, frames, and possibly contact lenses. Vision insurances have different options, as some may cover the whole eye exam fully or require payment for certain parts of the exam like the use of diluting drops. Most cover the cost of basic prescription lenses but do not cover extras like tinting, glare and scratch protection, or lens thinning. For frames, vision plans usually cover certain types of frames, or have set maximums that the plan covers, leaving the consumer to pay the difference. Some vision plans offer coverage for contact lens exams, and maximums for purchasing of contact lenses. Vision Service Plan has a vision plan that offers an allowance of up to $120 for contact lens exams and towards the purchase of contact lenses. Other providers offer similar allowances towards all services in their vision service plans, and some have discount offers for purchases of eye related material such as contact lens solutions, eyeglass frames, contact lenses, and even surgical procedures.

Another type of vision insurance is the vision discount plan that may cover regular eye exams, and offers discounts to members who visit network optometrists and stores. These discounts can go towards eye exams, eyeglass frames and lenses, contact lenses, and surgical procedures like Lasik. Spectra Vision Insurance provides members with a 15 percent discount for laser eye surgery through a partnership with the Laser Vision Network of America. Other vision insurance providers have partnerships with other service companies to increase the range of services offered to their members. Vision discount plans are designed more to supplement the cost of regular eye care visits and cost less than regular vision service plans.

The last vision service plan option is supplemental insurance through a company like Aflac, which offers a unique type of protection. Supplemental insurance may help cover the cost of exam fees, material fees, and other expenses not covered by regular or discounted vision service plans. For example, a regular vision plan may cover the cost of frames up to $120 dollars, but a consumer wants designer frames that cost $300 dollars. Some supplemental insurance plans cover the difference for this, and other features of the plan including eyeglass lenses, contact lenses, and other materials and fees. Supplemental vision insurance may also pay benefits toward eye related surgeries, vision correction, eye diseases or disorders, or permanent visual impairment like blindness. Supplemental is a backup insurance plan that can help when other insurances do not cover the complete cost, and lessen the burden for out of pocket expenses.

Considerations for Vision Service Plans

  • Out-of-Pocket Costs
  • Co-pays for services
  • Allowances for exams, eyeglass lenses and frames, contact lenses
  • Contact lenses exam coverage
  • Therapeutic or Diagnostic medication coverage
  • Need for approval for certain services
  • Deductible amount, if any
  • Time limits to plan, e.g. one exam per year per person
  • Flexible plan options

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