We all know health insurance is something you shouldn’t live without, but what about vision insurance? You can purchase vision insurance as a group benefit through your employer or as an individual policy. But how does the cost compare to the coverage you’ll receive?
Key Takeaway
- Most vision care plans provide discounts on laser eye-correction surgery.
- Vision care plans all have different offerings—some plans offer only minimal services; others may help cover treatments for eye surgery.
- Vision care plan benefits are not necessarily available every 12 months. It might be a longer time period, such as 24 months.
- There are two main forms of vision insurance that companies offer: plans that offer a predetermined percentage discount and vision packages that will pay a capped amount per service or eye care product.
- Vision insurance does not cover elective surgeries such as Lasik.
How Vision Insurance Works
When you have vision insurance, you send the vision insurer a check for your premium for individual plans or have the premium deducted from your paycheck for employer-sponsored plans.
In exchange, you’ll receive benefits such as discounted vision exams, glasses, and contacts. Some vision care plans require you to see a provider in the plan’s network. Other vision care plans simply require you to be treated by an optometrist or an ophthalmologist. In other words, you must visit a vision care professional who has graduated from an accredited college of optometry and is licensed by the state or who has gone to medical school and is certified by the American Board of Ophthalmology.
Purchasing a Plan
If you already have an eye doctor you want to keep seeing, make sure their services will be covered by the plan you’re thinking about purchasing. Whether you purchase your own insurance or get it through an employer, basic vision care plans range from $5 to $35 a month in premiums for an individual. To add coverage for a spouse, domestic partner, or child, you may pay slightly less per person than the plan’s individual rate.
If your employer offers vision insurance, you may only have one opportunity per year to sign up during the annual open enrollment period. Be aware that some individual plans charge a one-time enrollment fee in addition to a monthly premium.
Regardless of whether you obtain your coverage individually or through work, compare the policy’s total annual cost to your anticipated annual vision care expenses. You don’t want to pay out more than you expect to receive.
194.1 million
The number of Americans who use some type of vision correction, according to the Vision Council.
How Much Could You Save With Vision Insurance?
Generally, the only eye care covered by regular health insurance is due to illness, injury, or other major medical problem that involves the eyes. Health insurance does not cover eye exams, glasses, or related expenses. Without vision insurance, you are responsible for paying the full price for eye exams and any initial or replacement eyeglass lenses, frames, and/or contacts.
Generally, insurance companies offer two types of vision insurance: benefits packages that give you access to a capped dollar amount of services and products and discount plans simply give you a predetermined discount, such as 20% on qualified services.
The amount of savings generated by your vision plan will depend on how many new products and services you purchase in a year. For example, according to Vision Service Plan, the national average cost for the following products and services are as follows: $206 for an eye exam, $114 for a single lens, and $242 for frames, amounting to $562.
If you purchase a basic discount plan that costs $5 per month and that provides a 30% discount on all services and products, you would save about $108. Of course, plans and expenses vary, however, expect to save between $100 and $200.
Vision Insurance and Covered Expenses
Each plan covers a different set of expenses. Before signing up for any plan, check to see if it covers everything you expect to need. Bare-bones plans usually cover only eye exams, contacts, and glasses and may function more like discount plans than they do insurance.
The amount of eye-related expenses a vision insurance plan will cover differs significantly from plan to plan. One plan might charge you a $10 copayment for an eye exam and cover the difference. Another plan might pay for $35 of your exam and expect you to pay the rest. Also, if a plan does offer coverage for eye surgery or permanent vision loss, it may not be anything like the coverage you’re used to getting from health insurance.
Note that no vision insurance plan covers elective surgeries such as Lasik; however, some may provide members with a small coupon.
Example of Vision Insurance
The largest vision insurance provider in the United States is VSP Vision Care. Founded in 1955 by a group of optometrists, VSP currently has 88 million members and more than 40,000 doctors in its network.
VSP Vision offers two types of plans: Standard and EasyOptions. For the Standard plan, depending on your ZIP code, monthly premiums start at just $13 with an eye exam copay of $15, covering up to $150 in new frames. Though it does not cover Lasik, you can receive a coupon for an average of 15% off of your services.
The EasyOptions plan is a bit more expensive at around $24 per month. This plan has all the same benefits the Standard does but allows members to customize their benefits package by allocating more money toward the products they use more often.
What Vision Insurance Typically Covers
Vision insurance typically includes coverage for;
- annual exams
- glasses lenses
- frames
- contact lens fitting
- contact lenses
Providers may offer higher-tier plans that also include appointments for lens protection and LASIK surgery. Plans may cover certain brands and often have price limits or maximum amounts set for frames and contacts (the rest would be out of pocket).
Medically necessary eye surgeries and treatments for conditions like glaucoma and cataracts will usually be covered only by your health insurance.
Vision Insurance Plan Limitations
We’ve already touched on some of the limitations of vision insurance. Here are some additional factors to consider when deciding whether to purchase coverage:
- The plan might cover lenses for glasses, but only basic lenses. If you want lightweight or anti-glare lenses, you’ll have to pay the extra cost.
- The plan might cover frames but only up to a certain amount, so if you want a pair of $250 frames, only part of your cost will be covered. Or the plan might cover the retail markup of the frames and require you to pay the wholesale cost.
- Some plans will only cover glasses or contacts—but not both—during the same benefit period. If you wanted to update both your contacts and glasses, you would have to get contacts one year, then get another eye exam and choose the glasses benefit 12 or 24 months later.
- Some plans have waiting periods ranging anywhere from 30 days to 36 months. During the waiting period, you will receive either reduced or no benefits. The purpose of the waiting period is to prevent people from waiting until they have an expensive problem to sign up for vision insurance. The way insurance companies are able to pay benefits when people need them is by spreading risk among a large group of people. Some members are healthy and some are not; however, most will experience some issue, and at different times. Insurance companies need the premiums from healthy people to pay the expenses of unhealthy people.
- Fortunately, because the benefits of vision insurance are limited to vision correction products and services as well as eye exams, unlike health insurance, having a pre-existing condition will not raise your monthly premium.
Is Vision Insurance Worth It?
Whether or not it makes sense to purchase vision insurance will be different for each person and their situation. Consider how often you see an eye doctor and whether or not your prescriptions change frequently to help you decide if vision insurance is worth it for you.
The average eye exam without insurance can cost upward of $150, with the average pair of glasses with lenses in the $200 to $300 range.
Assume your average annual costs are one exam at $150 and a mid-range pair of glasses costing $250; your total annual out-of-pocket cost would be $400. If you paid $15 a month for 12 months for coverage, with an annual vision checkup and pair of glasses covered, you would save $220.
If your vision is fine and you just want a check-up every few years, vision insurance may not be worth it for you.
Alternatives to Vision Insurance
If vision insurance sounds too complicated, you don’t think you really need it, or you’re not sure if it will pay off, it’s fine to skip it. Unlike skipping health insurance, skipping vision insurance isn’t likely to land you in bankruptcy court or put your life in jeopardy.
There are a number of ways to get discounted vision care without purchasing vision insurance. Big-box retailers like Costco and Walmart have optical centers in some of their stores. The centers offer exams by licensed optometrists and sell reasonably priced glasses and contacts. Exam costs vary by location because the optometrists who staff them are independent of the retailers. Walmart lets you look at frames and their prices on its website.
If you’re not terribly particular about your frames, you can order a complete set of glasses through an online retailer at a stunningly cheap price. For example, how does $6.95 for both lenses and frames with $5.95 shipping sound? Some online stores will let you send them a pair of frames and they will add the prescription lenses. Discounted contact lenses are also available online. You will still need a prescription from an eye doctor when using these online services.
What Vision Insurance Does Costco Accept?
Costco Optical accepts most major vision insurance plans; however, these plans vary depending on the Costco location, Discount plans are not accepted.
What Vision Insurance Does Walmart Accept?
Walmart accepts most vision insurance plans but only for eye exams. Walmart offers its own vision insurance for customers wishing to purchase lenses, frames, or contacts.
Does Vision Insurance Cover Vision Therapy?
According to the Vision Therapy Institute, when insurance covers some of the costs for vision therapy, it is covered by health insurance, not vision insurance.
Can You Get Vision Insurance and Then Cancel?
Most vision insurance plans involve an annual contract, meaning that you must commit for a full year of coverage. Since many plans are offered through employers, you would typically need a qualifying life event to terminate existing coverage, such as leaving your job. Many plans do offer a 30-day grace period where you can cancel within that period just after signing up. If you do insist on canceling before your term is up, you will likely face early termination penalties and fees.
The Bottom Line
Deciding whether to purchase vision insurance can be tricky. It’s not unilaterally a good or bad deal. Whether it makes sense for you to purchase a policy depends on a number of factors, such as the policy options you have to choose from, the types of vision care products and services you need, and how frequently you need them. To make sure you’re getting a product that will be valuable to you, do the research and the math before you sign up.