After dental insurance, vision insurance is one of the most sought-after ancillary benefits. Although the term vision insurance is commonly used, these plans are often stand-alone plans that are better described as annual wellness benefits or discount plans. Vision coverage usually pays for annual examinations and may provide benefits for eyeglasses or contacts. Major eye issues, such as cataract removal or other eye surgery, are covered by major medical insurance in most cases. Elective vision correction, like LASIK, is not usually covered by medical insurance, but your vision coverage may offer discounts on such procedures.
Choosing Vision Insurance
If you obtain vision insurance through an employer, you may not have an option in companies as many employers offer vision coverage through one provider. If you do have a choice, however, there are things to keep in mind when you choose a provider.
Vision insurance is offered as either a benefits package or a discount on eye care and eyewear. Vision benefits packages may require a co-payment, but the balance is paid by the provider. In a vision discount plan, you pay for services yourself but at significantly reduced prices as long as you use participating eye care professionals. The first step in choosing a plan is to review the eye care services you and your family have used over the past few years as well as what you have paid for those services to determine which plan will work best for you.
Medicare
If you are covered under Medicare Parts A and B, together known as original Medicare, you are eligible for eye care benefits. Once you have met your Medicare deductible, you will pay 20 percent of the Medicare-approved amount for eye care services that are eligible. Medicare covers the cost of cataract surgery, including a standard intraocular lens. If you prefer an accommodating IOL or multifocal IOL to reduce the need for reading glasses after surgery, any amount above the cost of the standard lens is your responsibility. Medicare pays for eyeglasses or contact lenses after cataract surgery and also pays for glaucoma screening. The plan also pays for artificial eyes.
Medicare does not typically cover routine eye exams for glasses, but it does cover these and other services if you’re at a higher risk for glaucoma or you have diabetes.
Using Your Vision Insurance
Not all vision insurance companies require that you present an identification card at the doctor’s office. Often, the doctor can look up your account electronically and obtain all approvals that way. At the appointment, you will be required to pay any co-payments or discounted prices. In most cases, you are not required to purchase eyeglasses or contacts from your provider. There are online eyeglass and contact lens services that can sometimes provide you with products that are less expensive than those found at your eye doctor. Even if they are considered out-of-network, the savings can be substantial.
Vision insurance is a critical ancillary insurance product and more employers are offering the benefit as a way to retain and attract good workers. Not everyone needs vision coverage, but if you or your family has a history of vision problems, this can be a low-cost way to offset the cost of routine care. It’s important to know the basics of your vision plan to be sure it covers the services you and your family use on a regular basis.
