It’s well known, far and wide, that parenting is not easy. It’s also common knowledge that shopping around for insurance can be a chore. Because of this, when it comes to considering vision insurance for kids, many parents don’t know where to begin.
Read on to learn the basics of vision insurance for kids, including when coverage may be used, what can affect the cost, and whether it’s possible to get vision insurance only for your child.
At what age should my child have their vision checked?
Within the first year, it is recommended that your baby be screened three times to assess vision and eye development. During regular well-child visits, a pediatrician will perform the screening by shining a light in the child’s eyes to check pupillary reaction and eye alignment. If any problems are spotted, you’ll be referred to an eye care professional that specializes in pediatrics.
The InfantSEE program offered through the American Optometric Association also provides free eye exams for children aged 6-12 months. The program allows you to find a local participating pediatric optometrist and schedule a no-cost eye exam for your child.
After the first year, many children won’t be required to get another eye exam until age 3 and will have one every year from then until age 6, then every two years thereafter. If your child has a family history of pediatric vision issues, or if you notice any strange or abnormal behavior with your child’s vision, you should contact your pediatrician or an eye doctor. In some cases, more frequent eye exams may be required.
When might I consider vision insurance for my child?
As mentioned above, official eye exams typically begin at age 3, so some parents choose to have vision coverage by then. However, other parents might not enroll their children in vision insurance. There is no right or wrong answer — whether you enroll, and at what age, is up to you.
The level of coverage varies from plan to plan, but the main products and services covered by children’s vision insurance generally include:
- Eye exams
- Eyeglass lenses and frames
- Select extras like scratch-resistant lens coating
- Contact lenses
Can I get vision insurance for just my child?
Yes, there are options for only your child to be insured through public and private insurance plans. However, availability can vary depending on the plan's coverage and where you live.
Children’s Health Insurance Program (CHIP) is available for children who meet the eligibility requirements set by each individual state. If your child is eligible for CHIP coverage, you will generally not have to purchase any additional insurance for them. CHIP will cover vision and dental care, emergency services, immunizations, routine check-ups and more.
A perk with CHIP is that you don’t have to wait for open enrollment — you can apply at any time to find out if your child meets the state requirements.
Under the Affordable Care Act, pediatric vision care is classified as an essential health benefit. All individual and small group health insurance plans sold through the ACA Marketplace — as well as those sold off-exchange — must include vision coverage for children under 19. In most states, this includes an annual eye exam and one pair of eyeglasses per year, though copays and cost-sharing may apply. Large employer plans are not subject to the same requirement, though many still offer pediatric vision coverage. Vision screening and dental services for children is covered as preventive care at no cost under ACA-compliant plans.
Both of these options are provided on the state or federal level and are generally offered to households that make below a certain annual income, so not all families will be eligible. The plans also fall under health insurance with vision services included, but are not exclusively vision insurance coverage.
If your household income makes you ineligible for federal insurance plans, or you prefer only vision benefits, there are still private insurance options available.
There are several insurance companies that offer vision insurance coverage for kids. Each company has its own set of requirements and coverage details, so it's important to review each plan before making a decision.
How much is vision insurance for kids?
The amount you may pay for your child’s vision insurance depends on the plan you choose and other factors.
Private insurance plan costs vary based on the provider and plan type. Your premium can depend on factors such as:
Whether you get coverage through your employer or buy it directly
Whether the coverage is individual (only covers your child) or family-based
Copays and allowances for eye exams, glasses, contact lenses or other qualifying expenses
As previously mentioned, CHIP coverage and eligibility are determined by individual states. To get a more accurate estimate, apply your child for CHIP in your specific state.
Coverage cost for insurance through the Affordable Care Act depends on a few factors, like which level of coverage you choose and your annual income. You can review available ACA plans to estimate how much vision coverage would cost for your child.
Researching vision insurance options can take time and may feel confusing at times, but it can help you decide whether vision insurance is the right option for your child. For some people, it may help reduce out-of-pocket costs.
DOES YOUR CHILD NEED AN EYE EXAM? Schedule an appointment with a pediatric eye doctor near you.
