Choosing a Vision Insurance or
Vision Benefits Plan

By Madeleine Vessel

If you are among the more than 50 percent of U.S. citizens who wear prescription eyeglasses or contact lenses, you might consider taking advantage of a plan offering vision benefits. You can get a plan either through your employer or directly from an insurance or vision benefits company.

Company owners looking for an affordable way to attract and retain good employees also might think about adding vision coverage to employee benefits packages.

What Kinds of Vision Insurance Plans Are Available?

Vision insurance plans offer either a vision benefits package or discounts on eye care and eyewear.

A vision benefits package that covers services such as eye exams may require a co-payment from you at the time of service, with the balance to be paid by your plan. In a vision discount plan, you pay fully for services but at a lower-than-normal price that the plan's participating eye care practitioners have agreed to charge.

When you purchase vision insurance, whether it is a benefits package or a discount plan, you buy two products:

• Access to a network of eye care providers who have agreed to provide services and/or products at reduced prices (either to you or to the company administering the plan). These providers are typically optometrists and general ophthalmologists. In some cases, ophthalmologists who are refractive surgeons and provide LASIK and other vision correction procedures may be included.
• Specific eye care services and products, such as eye exams, eyeglasses and contact lenses.

Therefore, when choosing a vision insurance plan, you need to evaluate both the eye care provider network and the services being offered.

[Read more about understanding provider networks and types of vision plans.]

How To Evaluate Vision Benefits and Vision Discount Plans

To evaluate vision benefits packages and vision discount plans, first estimate your present and future eye care needs.

Begin by reviewing one or two years in your personal records to find out what kinds of eye care services you and your family members have used in the past and how many times these services were used by each family member. This information will give you an idea of what your future needs will be.

Then take a look at a number of available plans and ask yourself:

• Which vision plan provides services and products that meet my needs best?
• Which vision plan saves me the most money?
• Does the plan have quality assurance mechanisms and easy-to-follow grievance procedures?

Basic services typically include an eye examination with dilation, an eyeglass frame, a pair of eyeglass lenses and, in some cases, contact lenses. Refractive surgery, such as LASIK and PRK, may also be included.

A list of value-added eyewear products that might be covered under vision benefits could include progressive lenses, high-index lenses, polarized lenses, polycarbonate lenses, plastic photosensitive lenses, scratch-resistant coating and anti-reflective coating. [Read more about lens coatings.]

When analyzing the services offered by a variety of vision plans, use our Vision Plans – Benefits Comparison* (PDF ) and Vision Plans – Price Comparison* (PDF ) worksheets. The worksheets will give you a side-by-side comparison of up to three vision plans to help you decide which plan best meets your needs and budget.

*PDFs require the Adobe Reader plugin. Most browsers have it. If your browser doesn't have it, or if you'd like to update your version of Adobe Reader, please click here to visit the Adobe website and install it.

Note: For the "retail price" category, you can determine prices either by requesting estimates from each provider you want to consider or by reviewing your receipts from previous eye care purchases.

[Page updated January 2009]