In Wisconsin and throughout the U.S., only about 35% of people have perfect 20/20 vision. The rest of us need corrective lenses (or surgery) to restore 20/20 vision. However, vision care coverage remains conspicuously absent from most health plans or is only available as an add-on. Here’s what you need to know before choosing the best vision insurance in Wisconsin.
An Overview of Vision Insurance in Wisconsin
Under its BadgerCare Plus program, a healthcare program available for qualifying low-income households, Wisconsin offers vision care coverage for exams and eyeglasses. If you’re unable to qualify or prefer to choose your own coverage plan, several providers also offer standalone vision care plans, ranging from basic coverage for exams to more comprehensive plans with generous allowances for frames and lens options.
Vision care plans charge a monthly or annual fee, which can range from under $10 per month up to $40 per month or more for individuals, with the best values often falling somewhere in the middle. Expect to make a 1-year commitment.
Most plans also utilize a copayment, which is an amount you pay directly to your vision care service provider. Copays vary by provider and by the type of service you need during that visit. Some plans also offer an allowance for frames or enhanced allowances for select frame brands, which can reduce your costs dramatically.
One limitation that should be noted is that vision care plans, often called vision insurance plans, don’t cover corrective vision surgery. Instead, many providers offer discounts on LASIK surgery or PRK. Some plans may also require a waiting period before you are eligible for coverage for routine services.
Wisconsin Average Cost of Vision Insurance
Vision insurance plans use a different structure than other types of insurance. Some lens treatments may be included with the plan, whereas others may have a copayment or may not be covered at all by some plans. A better way to consider costs might be to view your potential out-of-pocket costs compared to potential savings by using a trusted vision care plan.
Using the cost savings calculator provided by VSP, a leader in vision plans, the savings become more apparent. The table below includes the plan cost, which can be as low as about $13 per month.
|Average exam cost||Average frame cost||Lens treatments||Out-of-pocket cost with plan||Out-of-pocket costs without plan||Estimated Annual Savings|
|$150||$200||Scratch resistance, UV protection||$304||$480||$176|
|$150||$200||Scratch resistance, UV protection, impact resistance, gradient tint, anti-glare, no-line bifocals||$546||$915||$369|
Savings increase as you add more lens options, but out-of-pocket costs increase as well. You’ll also see increased savings if you spend more on frames. Wisconsin residents spend about $200 on frames. However, because vision insurance plans don’t offer 100% coverage on many products and services, you may see higher out-of-pocket costs as well when choosing more expensive frames.
Most plans are structured with a combination of covered services — with or without a copayment — and discounted services for items that exceed your plan allowance or that aren’t covered by the plan. For example, with VSP, you’ll pay just $15 for an exam compared to an average of $150 if you had to pay out of pocket.
Frames may be covered up to a certain allowance. Using VSP as an example again, you’ll get a $150 allowance for frames and any amount above the allowance earns a 20% discount. If you purchase $200 frames, which is close to the average in Wisconsin, you’ll pay just $40. Your plan covers the first $150 and you’ll pay 80% of the remaining $50.
If you use more frame options, a higher-level plan may offer better savings overall, although you can expect to pay more monthly for the plan itself. Some providers also offer exam-only plans or other basic options, but if you need lens options you might find the overall costs higher even with lower monthly plan costs.
When is Vision Insurance Worth it?
Many health insurance plans don’t include vision coverage. Vision insurance plans are better thought of as vision care discount plans, and with the right plan, the savings can be significant. Here are some quick things to note:
- Medicare only provides routine vision care coverage if you choose a Medicare Advantage plan.
- If your employer offers vision insurance as a no-charge benefit or at a discounted rate, there’s no need to shop for a different plan unless your plan lacks features you need.
- Medicaid also provides limited coverage for vision care.
It’s difficult to imagine a situation in which a well-structured vision care plan isn’t worth the investment. If you or someone in your household needs corrective lenses, the savings make the investment worthwhile and flexible plan choices provide an easy way to fit vision care needs into any budget. However, it’s important to choose a plan carefully and be certain your plan fits your needs. In many cases, you’ll be making a 1-year commitment.
The Best Vision Insurance in Wisconsin
Choosing the best vision insurance depends on your family size and on which services you’ll need. Many providers offer a good-better-best plan structure that allows you to choose a plan that fits your vision care needs as well as your budget. Here are some picks to consider when choosing the best vision insurance in Wisconsin.
Best Overall: VSP
With a history dating back more than 65 years, VSP has grown to be the largest vision plan provider in the industry and offers a nationwide network of participating doctors and vision care outlets. VSP highlights its highest typical savings with its EasyOptions plan, which offers your choice of progressive lenses, light-to-dark tinting, higher frame allowance, or higher contact allowance included with the plan.
You’ll pay just $15 for standard exams with most plans and plans start at just over $13 for individual coverage. Most VSP plans also offer a standard frame allowance of up to $150, with a 20% discount on amounts above the allowance.
Best for Large Providers: EyeMed
Some Wisconsinites prefer their local eye doctor while others prefer the convenience of larger providers. If you’re in the latter group, take a closer look at EyeMed. Target Optical, Pearle Vision, and LensCrafters offer a wide network of independent care providers and you can enjoy no-hassle vision care on your terms.
EyeMed’s plans range in price from $5 per month up to $30 per month for individuals, although the mid-tier EyeMed Bold plan may strike the best value for many at $17.50 per month. EyeMed Bold’s eye exams are just $10, and you’ll get a $130 frame allowance. Lenses are just $20 and popular lens options such as UV treatment, tint, or standard scratch coating are available at no extra charge with this plan. Other options may cost more.
Best for Contact Lenses: UnitedHealthcare
As one of the largest healthcare networks on the planet, you can count on UnitedHealthcare to offer a wide choice of participating vision care providers. UnitedHealthcare’s vision care plans for Wisconsin residents also stand out for contact lens coverage in particular. UnitedHealthcare offers 2 plans in the state, both priced well under $20 per month for individuals. Plan A offers contacts in place of glasses with a $0 copay, while Plan B provides coverage for both glasses and contacts with a $0 copay for contacts.
For those who just want a stylish pair of glasses, UnitedHealthcare’s plans offer $10 exams and a frame allowance of up to $150.
Best for Frame Allowance: Davis Vision
Available through health insurance brokers in Wisconsin, Davis Vision offers a cost-effective way to save on vision care expenses. Davis Vision’s Designer Plan Classic only about $13 per month for individual coverage. However, a one-time application fee of $35 also applies for new customers.
Eye exams are affordable at $15 and Davis Vision includes a generous frame allowance of up to $175 for select frames. Many competing plans only offer a frame allowance of $130 to $150, making Davis Vision a standout in this regard. Several popular lens options are also available at no extra charge, including plastic lens coating, oversize lenses, and scratch-resistant coating.
Choosing the Best Vision Insurance in Wisconsin
As you choose the best vision insurance, invest some time in learning what’s covered and consider your total vision care costs. The vision care plan with the lowest annual cost might leave gaps in coverage that can be costly when it’s time to visit your eye doctor. Also be aware that most plans require a 12-month commitment, underscoring the importance of getting more than one quote so you can compare both prices and coverages.