Many employers in Michigan offer health insurance coverage but Michigan’s mandated coverage for group health insurance doesn’t include vision care for adults. Here’s what you’ll need to know when you choose the best vision insurance plan.
Quick Look: The Best Vision Insurance Companies in Michigan
A Glance at Vision Coverage in Michigan
Residents of the Wolverine State have several options for vision care but you may be surprised to learn that your existing coverage may or may not cover common expenses like exams, glasses or contact lenses. Many well-known health care programs have a coverage gap for vision care.
About 15% of Michigan’s 10 million residents are seniors covered by Medicare. Parts A and B of Medicare don’t cover routine vision care. Purchasing a Medicare supplement or a private-market Medicare Advantage plan may bring coverage but can include other expensive coverages that may not be needed. Often, the best option is to purchase a separate vision insurance plan.
Group insurance plans aren’t required to provide vision care coverage for adults in Michigan and employer-funded self-insurance plans aren’t governed by Michigan’s minimum coverage requirements. This means that children may not be covered for vision care in some cases.
Eye exams are covered as well as low-cost glasses if you qualify for Michigan Medicaid. Contact lens exams and contact lenses aren’t covered, however. Michigan children under age 19 without health insurance can qualify for MICHILD or Michigan’s Healthy Kids program, both of which provide basic vision care along with several other health care coverages. Pregnant women can also qualify for Healthy Kids. MICHILD and Healthy Kids are both designed to assist lower-income residents.
There are programs and supplemental plans that can cover vision care. These options are often basic and don’t cover common options, like contact lenses or lens treatments. A dedicated vision insurance plan can address these coverage gaps and make the cost of eye care predictable and more affordable.
Things to Look for in the Best Vision Insurance Companies
Vision insurance plans work differently than traditional health insurance plans in many ways. Typically, there’s no deductible for a vision care plan. There’s also no annual maximum out-of-pocket expense. Vision insurance plans play a similar role to traditional health insurance by making overall vision care costs lower and keeping out-of-pocket expenses predictable.
Most plans require a 12-month commitment. You’ll often have the option of paying monthly or paying for the whole year at once, the latter of which may earn a small discount. Your premiums purchase your membership in the plan, which then pays for common procedures using allowances for specific services.
For example, a plan may offer a $150 allowance for new frames once a year. Some services might require a copayment, which you pay to the doctor at the time of service, such as a $15 copayment for an annual eye exam.
The details of each plan can make a big difference for Michigan residents. The lowest-cost vision plans often provide a lower amount of coverage and lead to higher out-of-pocket costs. On the other end of the spectrum, it’s easy to overpay for vision insurance coverage. Choose your plan carefully to be sure it covers the services you expect to need for your family, without paying for services you’re unlikely to need.
Expect the focus for vision insurance plans to be on glasses, contacts and exams. Elective procedures, like LASIK or PRK, usually aren’t covered, but many providers offer a discount or coupon that can reduce the cost of treatment.
Here are some of the key vision care coverage features to consider for you and your family.
The monthly premium for vision insurance can range from under $10 per month to over $30 per month for individual coverage. Family plans cost more as a total premium but usually cost less on a per-person basis. You get what you pay for with vision insurance plans. The lowest-cost plans may provide reduced coverage or might provide a lesser value by changing coverage to a 2-year schedule instead of a 1-year schedule like many other plans.
Expect to pay a bit more for plans that target 1-year coverage. You’ll find several good options priced between $13 to $20 per month. Pricier plans cover more, but the cost of premiums can begin to compete with the cost of paying for out-of-pocket vision care.
Look for providers that offer annual exams. Typically, copayments for eye exams run between $10 and $20. Even if you don’t need a new prescription, annual exams are recommended and can sometimes even detect other medical concerns like diabetes.
Ample Frame Allowance
Most vision care plans use allowances to cover the cost of frames or contact lenses. Often, plans don’t cover both, so you may have to choose between both options or purchase a less expensive pair of frames if you plan to wear contacts most of the time.
An allowance is a fixed amount the provider will pay toward your frames. Expect to find a minimum of $100 as an allowance on most plans but plans with a higher allowance provide you with a wider selection of frames. Often, vision plans pay 20% of the cost above the allowance.
You’ll also want to pay careful attention to how often your plan offers new frames. Lower cost plans may limit coverage to once every 2 years. Coverage that provides new frames once a year is a better fit for many Michigan households.
Lens and Contact Lens Coverage
Frame lenses are usually covered with only a copayment paid by you. Copayments for lenses can range from $15 up to $65, but many plans have copayments of about $25.
Lens coverage usually includes single-vision lenses, bifocals or trifocals. Lens treatments, like no-line multifocal lenses or tinting are often extras covered by a separate provision in your plan.
Contact lenses are often covered in the same way as frames which makes your frame allowance interchangeable for contact lenses if you prefer to wear contacts. Expect to pay out of pocket if you want both contact lenses and glasses.
Coverage can vary greatly for lens treatments from one vision insurance provider to the next. Expect most lens treatments to require a copayment, although you may find some options available with no copayment.
For example, EyeMed offers popular lens options like UV treatment or tint (including gradient tinting) with no copayment for in-network purchases under its Bold Vision Benefits plan. Weigh each plan based on the lens options you use. The out-of-pocket costs for lens options can add up quickly with some providers.
Most vision insurance plans work like a health insurance PPO, which means you can often use out-of-network providers but it will cost you more.
In some cases, there may be no coverage at all for outside providers or the costs may be prohibitive. Examine the provider options in your area before you choose a plan.
Our Top Picks for the Best Vision Insurance Companies
You’re fortunate if you reside in Michigan because some of the best national vision insurance providers are available in your state. You can choose from vision plan providers that focus on independent eye doctors or those that focus on big eye care chains. Available plans range from the most basic coverages to premium plans with generous allowances for frames or contact lenses.
Many vision plans also offer the option to bundle dental insurance coverage, another health care expense often not covered by health insurance plans.
Best Overall: VSP
You can tell VSP what you expect to need and which service you’d like to cover and the VSP website recommends a plan based on your needs through its unique plan-chooser feature. You can get VSP’s $25 per month EasyOption plan or frame or contact lens allowances can be as high as $230.
You could also choose a still-generous $150 frame allowance and choose from 2 popular lens treatments without a lens option copayment. Budget shoppers can also select plans ranging from about $9 per month to $13 per month.
VSP’s network is massive and you’re nearly certain to find a great doctor nearby. Out-of-network coverage is available as well, but expect to pay a bit more for vision care outside of the network.
EyeMed provides plenty of great local options when choosing a vision care provider and focuses on national chains like Pearle Vision and LensCrafters as well as its own provider network.
Annual eye exams are covered by a low $10 copayment or are free with the EyeMed Healthy plan, a discount plan that does not provide allowances.
A trusted name in health insurance, UnitedHealthcare deserves a closer look for your vision care needs in Michigan.
Low copayments include a $10 in-network copay for exams and a $10 copayment for lenses. Frames come with a $150 allowance, which is higher than some similarly-priced competitors.
Provided coverages are available once per year and monthly pricing begins as low as $12 per month with a 12-month commitment.
Do you use popular lens options like UV coating, standard scratch-resistance or tint? Humana is a strong contender because all of these lens options can be purchased with just a $15 copayment for each lens treatment.
Annual exams have a $15 copayment while lenses have a $25 copayment, which applies to all lens types, whether single-vision or multifocal. Frames are given a generous $150 allowance once every 12 months and you can choose a doctor within Humana’s extensive network. Out-of-network services are available for some items but may cost more than in-network services.
Choosing the Best Vision Insurance in Michigan
Consider the big picture when choosing a vision insurance provider in Michigan. We found plans as low as $5 per month, but lower-cost plans may be simple discount plans that don’t provide allowances.
Weigh the different lens and coverage options you’ll need. Often, these can be among the most expensive elements of your eyewear purchase. Some providers may offer a lower copayment for some of your lens options or may include the option at no charge if you use an in-network provider. This means the best vision insurance plan may be different for you than for your neighbor.
Also, be aware of coverage frequency. Most plans revolve around a 12-month coverage but you may find some plans that only provide coverage for some items once every 24 months. Research these important details before making a purchase because many plans require a 12-month commitment.
Interested in reaching about more about finding good quality, affordable insurance? Check out Benzinga’s guides to the best homeowners insurance in Michigan, the best cheap car insurance in Detroit and the best affordable life insurance.