Vision plans are usually offered by employers in the form of discount coverage. This type of insurance is normally combined with indemnity health insurance (“traditional” insurance) or managed care programs such as a health maintenance organization (HMO) or a preferred provider organization (PPO). Employers will contract with local ophthalmologists and optometrists to obtain discounts in return for referring employees. If your employer does not offer a vision discount plan, you can purchase your own plan.
Vision insurance generally works similarly to HMOs or PPOs. You will choose from a network of predetermined providers and pay a small co-pay (on average $10 -$15) for services rendered. You may seek coverage outside of the network; however, you will pay a significantly higher cost. You will also have to pay for your services up front and then be reimbursed by the service provider. If you have indemnity health insurance, you can seek the provider of your choice without worrying about a network.
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What is Covered by Vision Plans?
Vision coverage helps offset eye exams, eyeglass lenses, frame discounts (some frames are fully covered; more expensive “designer” frames may not be, depending on your plan), and contact lenses (which are, in many cases, more expensive than eyeglasses). In some cases, LASIK procedures may be all or partially covered.
“Medical” procedures, though potentially referred by an eye doctor, would be covered or submitted to your health insurance. This would include surgery on the eye area that is not necessarily vision related (such as removal of a tumor).
Vision Plan Costs
As with any insurance coverage, vision insurance costs vary from program to program. Generally, with vision insurance, you can expect to pay a monthly premium up to $12; a co-pay of $10 to $15 for each network service; and a deductible up to $35 – along with expenses for uncovered procedures or out-of-network coverage.
With a vision discount plan, you can expect to pay a monthly premium up to $12; a predetermined discounted price for each basic service you seek from a network provider; and a deductible up to $35, plus expenses for uncovered procedures or out-of-network coverage.
Who Can Benefit From a Vision Plan?
Anyone who wears eyeglasses, contact lenses, or feels that they may need glasses or lenses should consider vision insurance. It can cut your costs considerably. As peoples’ eyes tend to worsen as they age, it isn’t a bad idea for young and healthy people to carry this option, either.
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