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What Does Vision Insurance Cover?

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Vision insurance reduces your eye care expenses in exchange for a monthly premium. It can offset costs linked to routine eye exams and provide discounts on glasses and contact lenses. These benefits aren’t covered under major medical plans (think Medicare) and are an elective aspect of your overall wellness checkups.

Want to know more about what vision insurance can and can’t cover? Start with our guide to learn more and find some of the best vision insurance providers. 

An Overview of Vision Coverage

Vision coverage is a health benefit that partially covers vision care, including eye exams and glasses. Vision insurance typically isn’t covered under the Affordable Care Act (ACA), but coverage for pediatric vision care is listed as an essential health benefit. All children under 19 years in individual or family markets are entitled to vision benefits.

Vision care coverage isn’t mandated for adults by the ACA. However, health plans may include adult vision coverage in their benefit design but aren’t required to do so. If your health plan doesn’t include vision coverage — on or off-exchange — you can buy a standalone plan from a private health insurance carrier.  

There are 2 common types of vision insurance:

  • Vision benefits plans differ in coverage between in- and out-of-network eye doctors. You’ll pay a percentage of your eye care cost through a deductible and copayments.
  • Discount vision plans mean you pay for your vision care at a lower rate.

Similar to health insurance, there are some restrictions you must understand, including in- and out-of-network care. Ensure you’re getting the care you want, particularly if you have a preferred eye care provider. 

It’s also important to be aware that out-of-network charges may be high. Ensure your deductibles and copays match up and examine the benefits to see what’s covered and what isn’t.

You can enroll in most vision plans anytime during the year. Some health policies also include vision or dental coverage, and you must sign up for those during open enrollment. Expect to pay as low as $10 per month for a vision insurance plan and a 12-month membership commitment.

It’s common for vision plans to require a copay. This is normally between $10 to $20 per item. Covered eye care services like scratch-resistant lenses or no-line bifocals (progressives) may have a higher copay. A majority of vision insurance plans are structured as a preferred provider organization (PPO) and you have access to both in-network and out-of-network specialists.

What Does Vision Insurance Cover?

Vision insurance typically provides coverage for basic care and eyewear. Most vision plans offset the costs of the following services:

  • Annual eye exams and vision tests
  • Eyeglass lenses
  • Eyeglass frames
  • Contact lenses
  • Lens protection like scratch-resistant coating

Some vision insurance plans may also have additional options for coverage on PRK and LASIK correction procedures at a discounted rate. Others may also cover lens enhancements for a small co-pay. Your insurance carrier may impose a limit on how often it will pay for frames and lenses. Vision insurance may not cater for eye care attributed to medical issues.

There are certain services and products vision insurance doesn’t cover. This varies by provider so be sure to inquire about the exclusions and limitations when you buy a policy. Some common exclusions include:

  • Non-prescription glasses like magnification reading glasses
  • Investigative or experimental procedures
  • Additional exams beyond 1 annually
  • Replacement of lost or damaged glasses unless the right warranty insurance is in place
  • Application fees, missed appointment charges or other miscellaneous charges

Average Cost of Vision Insurance

Premiums for vision insurance are usually paid monthly, and some carriers let you pay the yearly cost upfront. 

Most employers provide vision insurance as a benefit. If you can’t access vision coverage at work, you can purchase 1 for less than $10 per month. VSP, the largest vision insurance carrier in the U.S., offers affordable vision insurance plans starting as low as $13 per month. And, typical annual savings is more than $200 a year with VSP. 

Your plan can offset a portion of costs for exams, visits, glasses and contacts. The higher your premium, the less you’ll incur in out-of-pocket expenses for these services.

Here are your estimated savings on vision insurance in different states.

StateEstimated annual out-of-pocket cost with vision insuranceEstimated yearly out-of-pocket cost without insurance
Alabama$287$518
Colorado$268$521
Delaware$253$520
Maine$308$507
Utah$280$500
*Quotes were obtained using the following profile: A patient whose eye exam costs $200, spends $225 on frames and has no special lens enhancements. For an accurate quote based on your metrics, please use the VSP online calculator here.

When is Vision Insurance Worth it?

If you’re enrolled in a Medicare plan, you may wonder if Medicare vision coverage is available. It all depends on the type of plan you have.

Vision insurance is only worth it if you wear glasses. An annual eye exam is also an essential aspect of maintaining your overall well-being even if you don’t notice any vision problems. Whether you need basic glasses, want to save on your eye exam or fancy some designer frames with lens enhancements, vision insurance can help you make it happen.

The right vision plan can help you stay healthy, look great and save money. If you’re not sure about what you need, choose a vision plan that lets you customize your coverage.

How to Get Vision Insurance

Want to supplement your health insurance with a vision plan? Here’s how to get vision insurance:

1. Compare vision plans. Vision insurance providers are different, so start by comparing plans from various providers. Pay attention to aspects like copays, doctor network, inclusions, allowances and premiums.

2. Enroll online. Most vision insurance providers now let you enroll securely online 24/7. Just follow the insurance provider’s guidelines.

3. Pay your premium. You can only get covered after paying your 1st premium. This could be your 1st monthly fee or an annual upfront fee.

4. Enjoy your benefits. Review all your plan details, including eligibility and coverage start date. Find an in-network doctor near you and schedule an appointment.

The Best Vision Insurance Companies

Deciding what makes up the best vision insurance for you comes down to assessing your needs, calculating likely out-of-pocket expenses and balancing it against the vision benefits. Here are our favorite insurance carriers for vision insurance.

1. Best Overall: VSP

There are numerous vision plans offered by VSP, including individual coverage as low as $13 per month. Enroll in any plan online or by phone 24/7 to start a 12-month commitment. 

VSP boasts a network of 40,000 independently-certified doctors. VSP Individual Vision Plans also includes eye exam copays from $15. Frames and select lenses have a $25 copayment.

VSP also provides exclusive member benefits like an extra $20 to spend on featured frame brands. Members can also save up to 25% on non-covered lens enhancements through an in-network doctor. 

VSP has partnered with Guardian Direct to offer affordable dental insurance plans starting at $20 a month in most states. With comprehensive vision and dental coverage, your well-being is at the heart of everything VSP does.

2. Best for Large Network of Doctors: EyeMed

EyeMed lets you access over 66,000 independent eye doctors, optical retailers and top providers. These include nationally-recognized chains like Sears, Target and Pearle Vision. 

Its EyeMed Healthy vision plan starts at $5 per month. This plan includes a comprehensive eye exam after a $10 copay. You’ll also enjoy special offers and everyday savings from participating in-network providers. You’ll find discounts on LASIK, hearings aids and hearing exams.

EyeMed’s member portal lets you manage all your benefits in a single platform. Depending on the plan you choose, you can receive a 15% discount off conventional contact lenses and 40% of another pair of eyeglasses once the covered benefit has been used.

Best for Flexibility: Direct Vision Insurance

Underwritten by Ameritas Life Insurance, Direct Vision Insurance provides the flexibility of access to associated companies like VSP and EyeMed. Its individual plans come with a 30-day customer satisfaction guarantee. 

Direct Vision covers you from day 1 of your policy with no waiting period. The carrier also provides a $150 frame allowance. It charges a 1-time $25 enrollment fee at the time of your policy purchase.

Find Vision Insurance Today

A supplemental vision insurance plan won’t take a major cut into your insurance budget. With numerous options available, comparison shopping is the key to finding an affordable vision plan. 

Request free quotes from vision insurance providers, and evaluate the vision benefits, premiums and allowances. Take note of the coverage frequency. Some plans offer a 12-month coverage while others cover items once every 24 months. 

With a bit of research, you can easily find a plan that best matches your needs and lifestyle.

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