The Golden State has a number of excellent insurance providers but not all health insurance plans cover vision care. Here’s what you’ll need to know if you live in California and need vision insurance to help cover the cost of glasses or contacts.
The Best Vision Insurance in California:
- Best Overall in California: VSP Vision – See $13 Plans
- Best Customer Service: Davis Vision
- Best for Seniors in California: Humana
- Best for Custom Coverage: UnitedHealthcare
A Look at Vision Coverage in California
The federal mandate that required health insurance is gone for now but a handful of states have passed their own mandates. Expect California to join that group in 2020; California’s legislature just passed a state-specific mandate requiring all residents to get health insurance. Currently, about 93% of California’s residents have health care coverage.
The new health insurance requirements parallel those of the Affordable Care Act, and plans are required to offer basic coverages to qualify for subsidies and remain exempt from tax penalties. The Minimum Essential Coverage (MEC) requirements for California don’t include vision care or dental insurance, which means many Golden State residents will have to source coverage separately — or pay out of pocket.
Medicare has a similar coverage gap. Original Medicare coverage doesn’t cover comprehensive routine vision care expenses unless medically necessary. Coverage may be available with more expensive Medicare Part D plans or through supplemental plans. A better option for many California seniors is to purchase an independent vision insurance plan that fits your needs and budget — without the expensive extras.
It’s not uncommon to see price tags of $500 to $1,000 or more for California residents who purchase glasses, particularly those who need lens enhancements, like progressive or tinted lenses. Eye exams can range from $50 to $100. Expenses can add up quickly for households that have more than one person who wears glasses.
Vision insurance companies fill a gap in coverage where many health insurance plans don’t cover routine vision exams, glasses or contacts. Typical savings are often hundreds of dollars per year, which makes a vision insurance plan an attractive option and a great way to make vision expenses more predictable. In exchange for an annual or monthly premium, the cost of basic services, like eye exams, is greatly reduced. Glasses or contacts are usually paid for with an allowance through the plan.
Vision insurance plans typically don’t use a deductible. Instead, copayments are common, so expect to pay some of the cost for vision care — but less than if you have to pay the entire cost out of pocket.
What to Look for in the Top Vision Insurance Companies
Even though plan structures are often similar, the plan details can make a big difference in the overall cost of vision care. Two plans that have similar premiums can have dramatically different benefits and often depend on the specific services you’ll need.
There can be a big difference between low premiums and fair premiums. Low premiums mean you may have to sacrifice some coverage options or only be covered for new glasses once every 2 years. Most households benefit from plans that offer annual coverage.
You’ll also find plans that only provide exams, while others only offer discounts on glasses with no allowance provided. The lowest-cost plan may not be the best choice for many California households.
Plan premiums can range from as low as $5 per month to more than $30 per month for individual coverage. Families generally pay less per person. The best value is often found in mid-range plans priced at about $15 to $20 per month. Some plans offer a discount for paying for the full year all at once. A 12-month commitment is also common and helps to keep rates affordable.
Low-Cost Exams in California
Eye exam costs can range from $50 to $100. Most plans reduce this expense by including an annual eye exam. You’ll still pay a copay, which ranges from $15 to $35 in most cases. A plan with a higher copay for exams can be more expensive if you have a large family.
It’s important to get annual eye exams, especially for kids because children’s eyes can change rapidly as they grow.
Ample Frame Allowance
Some of the lowest-cost plans only provide a discount on frames. This structure can still result in large out-of-pocket costs when it’s time for new glasses. Better plans offer a frame allowance, which is usually at least $100 but can be as high as $250. For example, VSP, a leader in vision insurance, offers a plan with a $250 allowance when members select a featured frame brand. Another plan from the company offers $170 allowance when members select a feaured frame brand, with a $150 allowance if you choose a non-name brand.
A larger frame allowance can reduce or eliminate one of the largest expenses related to vision care. A plan that offers new frames once per year might be a better fit than plans that only offer frame replacement once every 2 years.
Frame allowances are often shared with contact lens allowances. For example, VSP’s standard plan offers a $150 allowance for frames but you can use the allowance for contact lenses instead. The plan pays 20% of the overage if your frames or contacts cost more than the allowance.
Affordable Copays for Lens Options in California
Lens options can be one of the costliest aspects of buying new glasses. You’ll want to evaluate the coverage for each plan based on the lens options you need if you use lens options such as progressive lenses or tinting. Lens options require a copay in most cases but you may find some plans that offer a small selection of lens options at no charge if you use a network provider.
Lens options can add up quickly and single options can have copays as high as $175. If you choose progressive lenses and tinting with one vision insurance company we reviewed, it can cost over $250 for the options alone. A well-known competing plan offers the same options for $50 and tinting is available without a copay.
Most vision plans use a preferred provider organization (PPO) network. This allows you to choose vision care providers outside of the network. However, coverage amounts tend to be measurably lower if you choose an out-of-network provider.
Some insurance companies focus coverage on vision care chains, like Target Optical or LensCrafters and others place a larger emphasis on a network of independent providers. Be sure to investigate which providers are covered by the plan you’re considering if you have a preferred vision care provider.
Expect to find more providers to choose from in more populated areas of California. You’ll also find more plans available if you live in a more populated area, like Los Angeles or San Diego.
Some plans only offer coverage for frames or other vision care items once every 2 years. Typically, 2-year restrictions are found with entry-level plans. If you spend a bit more for your plan, you’ll usually get new allowances once per year.
Premium price alone shouldn’t guide your purchase decision. It’s best to evaluate plans based on the total annual cost, including your out-of-pocket costs.
Our Picks for the Best Vision Insurance Companies in California
Golden State residents are fortunate because there are more vision plans available than in some other states. Choosing the best vision insurance is an individual decision. You’ll need to carefully evaluate each plan and price out your annual cost based on both plan premiums and the out-of-pocket costs you and your family will use.
1. Best Overall: VSP
We like VSP for several reasons, but one of the strongest benefits of VSP is the size of its network. VSP is the largest vision benefits company in the U.S. and has an expansive network of vision care providers.
A large network means you’ll have a wider choice of providers and it can also mean your coverage travels well and provides coverage options wherever you are — even when you’re out of town.
The Standard Plan is priced at $17 per month for individual coverage and the company estimates an annual savings of $278 per year compared to paying for vision care expenses out of pocket. Less expensive plans are also available, but you’ll sacrifice some features. For example, one plan may not cover exams and another plan may just provide an allowance for contacts or frames and lenses every other year.
Annual eye exams are covered with a $15 co-pay and you get a frame allowance of up to $170 when you pick a featured frame brand. Lenses have a fixed copay of $25, whether you need single vision, bifocals or trifocals.
2. Best Customer Service: Davis Vision
Davis is an affordable option for vision insurance in California — plans start at about $11 per month.
Many households are well-served by Davis Vision’s Premier plan, priced at under $14 per month for individual coverage. Annual eye exams are available with the Premier plan for a low $10 in-network copay.
Frames are covered up to $130 and select frames with a retail value of up to $175 are covered in full. Most lens options are priced affordably with Davis Vision and a number of options, like tinting or scratch-resistant coating, are available with no extra charge.
3. Best for Seniors: Humana
Availability may vary depending on your location in California, but if Humana covers your area, Humana’s $15-per-month plan deserves a closer look.
A number of popular lens options are available with an affordable $15 copay and frames come with a generous $150 allowance that renews annually. In-network eye exams are $15 and lenses have a $25 copay for single vision, bifocals or trifocals.
Contact lenses also come with a $150 annual allowance but covers either frames or contacts. Humana has a strong network in California and we found hundreds of local providers in many areas of the state.
4. Best for Custom Coverage: UnitedHealthcare
United Healthcare has a vast network of vision care providers and it’s the largest health insurance company in the U.S.
You’ll save on annual eye exams (it’s about $16 per month for individual coverage) with a $10 copay and you’ll get a $150 allowance for frames or contacts.
Lenses have a low $10 copay for single vision or multifocal lenses. Coverage for both glasses and contacts is available as well. Lenses include standard scratch-resistant coating. Other lens options may have additional costs.
Choose Vision Insurance in California
Finding the best vision insurance depends on how you and your family will use the plan. VSP offers a compelling value for general coverage. If you use certain lens options, however, Davis Vision or Humana may be better options. It’s important to price out the annual vision care costs for your family by evaluating the premiums and the cost of individual expenses, like copays for frames and lenses. Since 12-month commitments are common for vision care providers, evaluate the cost and benefits of each plan carefully.
Frequently Asked Questions
1) Q: What types of vision plans are available to me?
Generally, there are just two types of vision plans: benefit plans and discount plans. They usually cover the same types of exams and products but there will be a difference in monthly premiums. You can expect to pay much lower for the discount vision plan.
2) Q: What’s typically included with vision insurance?
Eye exams and prescription lenses are typically included with your vision coverage. Some companies pay for all of the costs and other times there will be a co-payment required for the services received or the lenses that you choose.
3) Q: Can I get vision insurance through work?
Yes, depending on your employer you can get vision insurance covered. You might have to pay a portion of the premium, however.