Vision Insurance

Vision care insurance is insurance that provides coverage for services relating to the care and treatment of the eyes. It typically covers services delivered by an optometrist or opthamologist. Depending on the specific plan, some or all of the following services may be covered:

  • Yearly eye exams
  • Glasses (with an annual limit)
  • Contact lenses and fitting (with an annual limit)
  • Glaucoma screening

Some vision plans may provide more extensive coverage (such as certain eye surgeries), while others may limit coverage to “reasonable and customary” charges incurred during routine eye exams. Reasonable and customary charges generally don’t include the cost of glasses and contact lenses. With some employer-sponsored vision plans, coverage may be even more narrowly limited to the medical treatment of certain eye conditions. This is rare, however.

How much does it cost?
Vision care insurance is generally available for a small, nominal annual premium (often as little as $50 a year). What’s more, your employer may pay the premium, or part of it, thereby further reducing your cost.

How does it work?
Vision care insurance may provide direct payment to the eye care provider for the services you receive. Or you may be required to cover the charges out-of-pocket at the time of service, and then file a claim for reimbursement. It depends on the specific plan.

Where do you get it?
Almost everyone who has vision care insurance gets their coverage through work. Employer-sponsored vision care plans may be self-funded or self-administered plans. Vision insurance may also be part of an employer’s group health insurance plan, or one of several options from which employees can choose under an employer’s cafeteria benefit plan. Commonly, an employer will purchase group vision insurance through an HMO, insurance company, or other organization that offers group vision care plans.

Individual vision care policies are scarce because they’re generally not cost effective from an insurer’s standpoint. If you don’t have access to vision care coverage through your employer, you will likely have a difficult time obtaining this kind of insurance through an individual, stand-alone policy. Some individual health insurance policies may include vision coverage, however, or allow you to add it for a slightly higher premium.

Who should have it?
Anyone who has access to employer-sponsored vision coverage should probably take advantage of it because the minimal cost is outweighed by the benefits. If you don’t have coverage and you have no vision problems, you should probably just forego vision insurance and “pay as you go” for annual eye exams. However, if your vision expenses are relatively high (glasses, contacts, etc.) and you don’t have employer coverage, you may want to look into other ways of obtaining vision insurance.