Vision Plan
Vision insurance is a health and wellness plan designed to reduce your costs for routine preventive eye care and prescription eyewear. Unlike medical plans most vision insurance plans are discount plans that provide specific benefits and discounts for an annual premium.
Vision Insurance
Things to consider before enrolling in a vision plan
When purchasing "vision insurance," be sure you fully understand the costs and benefits associated with the plan(s). Below are some questions to consider:
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What are your current annual vision expenses?
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What is the cost of the plan compared to the covered services?
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Can you get coverage through your spouse’s plan or some other discount plan?
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Does your current medical plan offer vision benefits?
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Are you willing to change vision providers if your current provider is not in the network?
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Does the plan require you to purchase the eyeglasses from the person who provided the exam?
Services that are generally covered by a vision plan Typically, a vision benefits plan provides free eye care services and eyewear within fixed dollar amounts in exchange for an annual premium or membership fee and a relatively small co-pay each time you access a service. A discount vision plan, on the other hand, provides eye care and eyewear at discounted rates after you pay an annual premium or membership fee. Vision plans generally cover or provide discounts on the following products and services:
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Annual eye examinations
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Eyeglass frames
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Eyeglass lenses
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Contact lenses
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Discounted rates for LASIK
Typical limits provide for examinations once every 12 months, lenses once every 12 or 24 months, and frames once every 12 or 24 months. Services and appliances that are not medically prescribed are generally not covered. Always refer to your plan details for complete information on what services are covered by the plan.
Managed Eye Care Like medical plans, vision plans with a managed care approach require that you obtain care through a network of participating providers. These providers are responsible for and monitor your overall eye care treatment. You may be referred to a specialist if you need medically necessary treatment, such as cataract surgery. You also have the option to go outside the network, but you will be responsible for additional charges which exceed the benefit amount limits. These limits are typically below the “usual and customary” fees which means you will have to pay the retail fee for the service.
Selecting a Vision Care Provider
Choosing an eye care professional is an important decision. You need regular eye exams even if you do not notice any vision problems. If you are experiencing vision problems, the nature of the problems may determine the type of eye doctor you choose. There are two types of eye doctors:
An Optometrist performs eye examinations and writes prescriptions for corrective lenses. Most Optometrists can diagnose and treat some medical eye conditions and prescribe certain medications.
An Optician is trained in fitting and fabrication of glasses and contact lenses that have been prescribed. They cannot perform eye exams or prescribe glasses.
An Ophthalmologist is a medical doctor treating eye diseases and conditions. Ophthalmologists perform surgery for cataracts and other eye conditions.
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Determine if the eye doctor is an authorized provider under your insurance plan. Typically, you can get this information by calling the doctor's office and giving them your insurance information or consulting your insurance plan.
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Optometrists and Ophthalmologists use a refraction test to determine the appropriate lens power needed to compensate for any refractive error (error in the focusing of light by the eye). Ask your eye doctor what refractive tests they offer, as new technology can reveal more about your eyes to create a better vision correction.
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When inquiring about services, ask what types of lenses the practice offers as all lenses are not created equal. The lens choice can make a big difference in the quality of your visual experience.
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Be sure to get a copy of your prescription should you need to replace your glasses while you are on vacation or traveling.
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Ask your friends, family and co-workers for doctor suggestions.
Additional Resources
The American Optometric Association contains informative articles on everything from "Keeping Your Eyes Healthy" to "Directory of Eye Care Tips of the Month."
The American Academy of Ophthalmology website includes valuable information to assist you in locating ophthalmologists in your area, contains a quiz on eye care facts and myths, and links to academic, medical, and governmental resources on the Internet.