Eye care plans: What is vision insurance?
Vision insurance is a specific type of health and wellness plan designed to make eye exams and prescription eyewear more affordable. Some vision insurance plans also offer discounts on LASIK and other elective vision correction surgery.
Traditionally, vision insurance has provided coverage for preventive eye care services and products, eye conditions and diseases, and the treatment of eye injuries.
Vision insurance typically has been part of a comprehensive health insurance plan offered by health maintenance organizations (HMO) and preferred provider organizations (PPO) that contract with managed vision care networks to provide eye care services. However, the term has expanded to include wellness and discount vision care plans offering specific benefits for an annual premium.
Vision insurance and vision benefits plans often are included as part of a health benefits plan offered by employers to their workers. Individuals also can purchase these plans themselves to help make their eye care and prescription glasses and contacts more affordable.
Items covered by vision insurance
Specific examples of items covered by most vision insurance plans include eye exams, prescription eyeglasses, contact lenses, progressive lenses, photochromic lenses and anti-reflective coating. The typical vision benefits package usually provides free eye care services and eyewear within fixed dollar amounts for an annual premium or membership fee, plus a copay each time you access a service.
By comparison, a discount vision plan provides eye care and eyewear at discounted rates for an annual premium or membership fee. Specific discounts or allowances for products and services vary from plan to plan.
How vision insurance works
To summarize, vision insurance can be available through an employer as a group benefit, or vision insurance can be purchased as an individual policy. In the first scenario, the employer-sponsored plan often deducts some or all of the insurance premium from the employee’s paychecks. In an individual vision insurance plan, the insured sends a check to the insurer, usually on an annual basis. It’s important to note that some vision care plans require subscribers to choose a provider from the plan's network. Other plans are more flexible, allowing you to choose any optometrist or ophthalmologist near you. If you already have an eye care professional that you would like to continue using, be sure to check that he or she is covered by the vision insurance plan you are considering.
How to choose a vision insurance plan
Finally, if you are choosing an individual vision insurance plan, be aware of its limitations. Basic plans often cover just eye exams, glasses, and contact lenses. More comprehensive plans may expand coverage to include eye surgery, laser eye surgery, and treatment of common eye diseases like cataracts and glaucoma.
Make sure the plan you choose covers the products and services you think you’ll need.
Page updated January 2021