The eyes are essential organs. When something is wrong with a person’s sense of sight, it can lead to big problems. If a person experiences an eye problem, it can be a challenge to function every day.
Health care insurance is there to protect a person’s general wellness. Eye insurance is there to protect our sight. Vision insurance can be beneficial for preventive care, covering eye exams and other vision-related medical care. How important is vision insurance, and what does it cover? Let this post be your helpful guide.
What Is Vision Insurance?
Vision insurance typically covers eye exams, glasses, contact lenses and sometimes, eye surgery procedures like LASIK. Eye and vision coverage care is not required for adult health insurance plans under the Affordable Care Act (ACA). However, eye coverage is required on health insurance plans for children younger than 19 years of age.
While some health insurance plans may choose to include some vision coverage, the vast majority do not. For adults then, it is always better to have vision insurance along with your health insurance plan, especially if you have eye or vision problems.
Vision Insurance Vs. Vision Discount Plans
There are different types of vision insurance plans, just like health insurance or dental insurance plans. These include Preferred Provider Organization (PPO) plans, Health Maintenance Organization (HMO) plans, Point of Service (POS) plans and Indemnity Insurance Plans.
The above are all types of vision insurance. It is important to distinguish between vision insurance and vision discount plans, which are not actually a type of insurance. Here are there differences:
- Vision Insurance Plans: This type of plan is a true insurance policy where you pay a monthly fee (premium). You should have coverage for frames, contact lenses, annual eye exams and other eye care. Each time you have to use one of these services, you may have to contribute a payment (copay, deductible or coinsurance).
- Vision Discount Plan: With vision discount plans, you will just get discounts on certain eye or vision services. It is not a form of vision insurance, as you are not actually “covered.” You may have to pay to join the discount plan.
What Does Vision Insurance Cover?
In general, vision insurance plans cover the expenses for basic eye care and eyewear. Here is what most vision insurance covers:
- Annual eye check-ups and other basic preventive care
- Vision Tests
- Prescription Eyeglass Lenses and Frames
- Prescription Contact Lenses
- Lens Enhancement or protection (e.g., Anti-scratch coating, Transition Lens)
Companies may allow you to add on coverage for PRK or LASIK surgery. PRK (Photorefractive Keratectomy) uses laser technology to correct vision problems caused by refractive errors. LASIK surgery (Laser in-Situ Keratomileusis) is a surgery done to correct nearsightedness, farsightedness or astigmatism. In some cases, PRK and LASIK surgery are covered for those with vision insurance. Both surgeries are add-ons to your eye care insurance. Make sure to inquire about this matter with your insurance provider before you take out a policy.
What Does Vision Insurance Not Cover?
Remember that you can always have add-ons and confirm the inclusions and exclusions. But in general, eye insurance plans do not cover the following:
- Reading Glasses
- Fashion Glasses
- Non-prescription glasses
- Fashion contact lenses
- Experimental Procedures
- Replacement of damaged glasses (depending on the warranty inclusions)
- Replacement of lost glasses (depending on the warranty inclusions)
- Application Fees
- Fees for missed appointments
- Miscellaneous Fees
How Does It Work?
When paying for your Vision Care Insurance premium, you will pay the premium directly to the company each month. If your plan is sponsored by your employer, it will instead be deducted from your pay-check.
The accredited vision care professionals that you can visit are optometrists or ophthalmologists. They must have these qualifications:
- Graduates of Optometry or studied in a medical school
- Licensed by the state
- Certified by the American Board of Ophthalmology
How to Get a Vision Insurance Policy
Once you decide to invest in a vision insurance plan, do your research and look for the best options. Assess your needs, consult with family members and calculate the expenses to see if it fits in your budget. Here are the steps and some tips if you want to get vision insurance:
- Do Your Research: Be wise, do your research and compare the best vision insurance plans in the market. Compare the services they cover and do not cover, and orient yourself with every little detail. It would be best if you looked for participating eye care doctors in your area to make sure they are in your plan’s network. Pay attention to the amount for the deductible and premium payments. Remember that fashion glasses or non-prescription glasses are not covered.
- Enroll Online: Nowadays, most eye insurance companies let you enroll online at any time of the day. Register online, read the instructions and review the insurance provider’s guidelines. If you have doubts, you can always give them a call for any clarification. For some, there are 24/7 customer service or insurance agents to answer any questions.
- Start Paying Your Premium: For most vision insurance providers, the coverage starts on the first premium payment. You have the option to pay monthly or an annual fee.
- Use the Benefits Anytime: Enjoy your benefits and use them anytime if you have coverage. Make it a habit to have annual eye exams. If you’re wearing prescription glasses, have your eyes checked for changes in your eyesight. Make sure to review your coverage details, eligibility, start date and finish date. Look for an eye doctor near your area and schedule the appointment.
When Is the Best Time to Use Your Vision Insurance?
Even when you are not experiencing problems, make use of your vision insurance and have an annual eye exam. This is to make sure to prevent eye problems and have optimal eyesight.
Once you experience eye problems, schedule an appointment as soon as possible. Signs and symptoms of possible vision problems include:
- Eye pain.
- Blurred vision.
- Change in vision.
- Frequent, unexplained headaches.
- Sensitivity to light.
- Any discharge, itching, swelling or burning in the eye.
Have your eyes checked as soon as possible and make use of your eye insurance plan. If it’s bothering your daily activities, do not wait for the problem to become worse. You will never know what could happen, so it’s better to be prepared and have your eyes insured.