Virginia health insurance providers aren’t required to provide vision insurance for adults as part of your coverage. The annual cost for glasses or contacts can be hundreds of dollars per year. Here’s how to choose the best vision insurance coverage for you and your family.
The Best Vision Insurance in Virginia:
- Best Overall in Virginia: VSP Vision – See $13 Plans
- Best for Claims: Davis Vision
- Best for Combining Coverage: Humana
A Glance at Vision Coverage in Virginia
Health insurance requirements in Virginia parallel those of the Affordable Care Act (ACA), which mandates vision care coverage for children on most plans but does not require coverage for adults. Many employer-sponsored plans provide optional vision insurance coverage but not all employers offer health insurance. Nearly half of Virginia’s residents aren’t insured through an employer-sponsored group health plan.
Medicare recipients, who make up about 15% of Virginia’s population, face a similar challenge because Medicare Parts A & B don’t cover routine vision care. Seniors who need glasses or contacts may have to pay for vision care expenses out of pocket unless they purchase separate coverage. Medicare Advantage plans and supplemental plans may have coverage for vision care but can also bundle extra coverages that you don’t need. Often, the best solution is to purchase a standalone vision insurance plan that focuses on vision care without the expensive extras.
Most Vision insurance plans don’t meet the state’s definition of insurance and are better described as benefit plans. Some lower-cost plans function like simple discount plans while more comprehensive plans cover a larger scope of vision care expenses. This can save, potentially saving hundreds of dollars per year when compared to paying for vision care coverage out of pocket. About 75% of adults wear glasses or contact lenses and it isn’t unusual for glasses to cost over $500. If your prescription changes year-to-year, the costs can add up quickly.
Vision care plans, often simply referred to as vision insurance, can help reduce the annual cost of vision care significantly. An added benefit is that out-of-pocket costs become more predictable because monthly premiums help prevent large bills from the eye doctor.
Monthly premiums for vision care plans start as low as $5 per month for individual coverage and can be over $30 per month. However, most plans are priced at about $15 per month for individual coverage and offer compelling value at that level. Family coverage costs more but usually offers a lower cost per person.
In exchange for your premium, a vision care plan pays the lion’s share of most basic vision needs like exams, lenses and frames, and some contact lens options. Most vision insurance plans don’t use deductibles. Instead, expect to pay a copayment for many services. Typically, copayments are small but they can add up, so it’s important to weigh the costs with copayments in mind when choosing a vision care plan.
You can use your tax-free savings to pay for vision care expenses, including copayments if you have a hHealth sSavings aAccount (HSA) or a fFlexible sSpending aAccount (FSA). Plan premiums aren’t eligible expenses, however.
What to Look for in the Best Vision Insurance Companies
It’s common for vision insurance plans — and even dental insurance plans — to require a 12-month commitment. You’ll want to choose carefully and weigh the plan features that are important to you and your family.
Eyesight can change quickly and the prescription you got last year can leave you struggling to see a year later. Sometimes, conditions like farsightedness can actually improve, which means old prescriptions can even cause eye strain. The same is true for children and adults who struggle with nearsightedness. UsingUse of computer screens and mobile screens can contribute to myopia (nearsightedness), which makes annual exams a must.
Most plans cover the cost of an annual exam but require a copayment, which can range from $10 up to about $30. A handful of plans don’t cover eye exams. Expect to pay between $50 to $100 for your exam if your plan doesn’t provide coverage.
Premiums for individual coverage can range from $5 per month to over $30 per month. Expect the least expensive plans to be no-frills and more expensive plans may result in paying for more coverage than you need. The best value is often found in mid-tier plans. You’ll find these mid-tier plans to be largely similar amongbetween vision care plans but with some important distinctions. Plans priced at about $15 per month offer an attractive value in most cases and can save hundreds of dollars per year on vision care.
On average, Virginians spend about $200 on a pair of frames. The frame allowance for a vision care plan refers to how much the plan will pay toward your frames. Most plans set a floor at about $120 but it isn’t uncommon for plans to offer $150 or more as a frame allowance. Some brands may earn an even higher allowance, as is the case with VSP’s featured frames, which offer a $170 frame allowance. Amounts above the allowance are usually paid at 20% and the consumer pays the remaining 80%.
A higher frame allowance can help reduce out-of-pocket costs but you’ll also want to consider the frequency of coverage. Some plans only provide a frame allowance once every 2 years. Plans that allow you to change frames once a year are a better fit for many Virginians. Prescriptions can change quickly and with a 2-year allowance frequency, you may be forced to pay for new glasses out-of-pocket.
Lens coverage is typically handled using a copayment rather than using an allowance. A copayment is paid directly to the service provider at the time of purchase. Expect to pay about $25 toward your lenses, but that doesn’t include any lens options you might need. Copayments are generally the same regardless of whether your lenses are single focus, bifocals or trifocals but can be higher or lower than $25, depending on which plan you choose.
Lens options, like tinting or progressive lenses, are where you’ll find the biggest variance in cost from one vision care plan to the next.
Most vision insurance plans assign the same allowance for frames or contact lenses, although some plans might offer different allowances for each. You might have to choose between glasses or contacts, depending on your plan. Look for a plan that offers an annual allowance if you use contact lenses.
A lens option is an add-on or treatment for lenses that can make life easier with your new glasses. Common options include tinting or gradients, progressive multifocal lenses and scratch-resistant treatment. It’s important to learn the cost of the options you’ll use for each member of your family. For example, no-line progressive lenses can cost nearly $180 with some plans but have a copayment under $70 with other plans.
Considering only the monthly premium or frame allowance when you choose a vision insurance plan can lead to costly surprises at the point of sale if you haven’t evaluated the copayments for the options you use as well.
Vision insurance plans are commonly structured as pPreferred pProvider oOrganizations (PPOs). You can choose service providers inside or outside of the network. However, coverage levels are usually lower for out-of-network providers, and some services may not be covered at all if you choose a provider outside of the PPO network.
Consider plans and networks thatin which your doctor participates in. Often, you’ll find more than one. VSP is the largest vision care coverage provider and has the largest independent network of doctors. Other providers, like EyeMed, offer better coverage for large eye care chains like LensCrafters or Target Optical. A larger network offers more choices if you don’t yet have a preferred eye doctor.
Expect plans to focus on eyewear and exams. Corrective surgery, including PRK and LASIK aren’t covered but most plans offer a discount on these procedures through recommended doctors.
Our Picks for the Best Vision Insurance Companies in Virginia
Virginia has fewer standalone vision care plans available than some other states but residents of the Old Dominion can choose from some of the best vision insurance companies available in the nation.
While there are qualities common to vision care plans that can benefit most Virginia households, each family’s needs are unique, and it’s important to weigh the pros and cons of each plan foras it relates to your household.
1. Best Overall: VSP
We like VSP for a number of reasons but the size of the network is near the top of the list. As the largest vision care coverage provider, VSP is a trusted partner featured in many employer-sponsored health care plans but you can also purchase coverage independently.
Plan prices for individual coverage begin at under $10 per month in Virginia. However, VSP’s standard coverage, priced at about $14 per month, offers an exceptional value with annual exams covered for only $15, lenses available with a $25 copay and a $150 frame allowance. Selected frames from several famous makers earn an extra $20 frame allowance with VSP’s plans.
2. Davis Vision
Available through brokers for Virginia residents, Davis Vision has been providing vision care benefits for over 50 years and has a vast network of over 93,000 points of service. Davis Vision is partnered with many top eyewear retailers to provide affordable vision care. The company also has a large network of independent eye care providers.
Virginia residents can choose from 3 plans available in the state and the most comprehensive coverage offered through Davis Vision’s Premier plan is under $14 per month for individual coverage. Annual eye exams are only $10. Selected frames are covered fully, a value of up to $175. Other frame selections are eligible for an allowance of $130, which renews annually.
The Vision Focus Plan available through Humana offers $10 annual exams when you use doctors within Humana’s network. The frame allowance for this plan, at $100, is lower than you’ll find with some competing plans.
However, contact lenses have a higher allowance of $115 and Humana’s lens options have lower copayments than many competitors. UV coating, tint and standard scratch resistance are all available with a $15 copayment each. Progressive lenses for bifocals are $65. Copayments for both the lenses themselves are $25 for single-focus or multifocal lenses are $25.
Choosing the Best Vision Insurance Plan in Virginia
Premium costs only tell part of the story when you choose a vision insurance plan. The parts of your plan to consider carefully are the frequency of benefits (1-year or 2-year benefits), the allowances, which can range from $100 for frames up to over $200, and the cost of lens options. Not everyone uses lens options but if you or your family does, the cost difference from one vision plan to the next can be significant.
Frequently Asked Questions
1) Q: How do I ensure that I’m properly covered?
Speak with an agent or your carrier directly to determine if you have appropriate coverage to meet your needs. Vision insurance can be customized; if you want more or less coverage you can do so by altering your policy.
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: 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.