A Brief Overview of Vision Care Coverage

February 23, 2017

In the current economic downturn, many employers are re-vamping their employee benefits programs. Unfortunately, one of the first benefits to be cut is vision care coverage. The result of this is that many people end up putting off regular eye exams and only going to see an ophthalmologist or optometrist when a serious vision problem crops up.

If you or a family member has existing and/or ongoing eye care needs, you should consider purchasing individual vision care insurance to replace what your company no longer provides. If you’ve never needed vision care, consider that roughly 40% of people over forty need some kind of corrective lenses.

What Does Vision Care Insurance Actually Cover?

Details vary between providers and plans, but most vision care policies provide:

  • discounts for annual eye exams
  • discounts for contact lenses OR eyeglasses, usually one or the other each year
  • discounts on eyeglass frames once every two years
  • LASIK may be covered, or partially covered, only if it’s deemed medically necessary

Why is Vision Care Important?

In addition to basic things like identifying the need for corrective lenses, and providing them, regular eye exams can also be early detectors of a variety of medical conditions, like glaucoma, high blood pressure, diabetes, liver disease and even brain tumors.

As well, the condition of your eye can also be an early warning of nutritional deficiencies you may be suffering from.

Who Provides Vision Care Coverage?

Most vision care insurance is offered either as part of a preferred provider organization (PPO) which contracts with eye care professionals (ophthalmologists and optometrists) who provide services in exchange for a co-pay, though you can visit other eye doctors outside of the network. If you choose that route, you’ll likely have to pay first.

As to insurers, most mainstream insurance companies offer vision care coverage only as part of individual health plans, but even if your company stops offering vision care this way, chances are good that you’ll still be able to be part of VSP, the Vision Service Plan, which will give you discounted services, though not quite as comprehensive coverage as actual insurance.

If you have medical coverage through Medicare, basic vision must be purchased separately, however, Medicare coverage does pay for annual glaucoma tests if you are in a high-risk group (diabetes patient, African-American, Hispanic, or have a family history) for it, and it will also cover basic cataract surgery and eyeglasses that may be necessary afterward.

These are just some of the key areas that vision care plans address. For more information, consult your company’s benefits coordinator or your insurance agent.