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What is Vision Insurance and how does it work?
Vision Insurance is typically a supplemental insurance to other types of medical insurance policies. Vision insurance will help offset the costs of routine checkups as well as help pay for prescription glasses or contact lenses. Some plans also offer discounts on corrective surgery such as LASIK.
Most vision insurance plans are discount plans or wellness benefit plans that provide specific benefits and discounts for an annual premium. Make sure you read and fully understand the costs and benefits associated with the plan you have purchased. If you have vision care coverage through a plan at work, be aware that “vision insurance” plans usually operate differently than other health insurance plans or major medical insurance.
We suggest you speak to your eye doctor to advise you of the specific benefits of your vision plan prior to your exam and eyewear purchase so there are no surprises afterward.
What Kinds of Vision Plans are Available?
Group vision insurance can be obtained through your work, certain associations, school districts, etc., or through a government program such as Medicare or Medicaid.
If you are not eligible for a group plan because your employer doesn’t offer insurance, are self-employed or for other reasons, most vision insurance providers also offer policies that you can purchase individually.
Vision Insurance is typically an added benefit linked to Indemnity Health Insurance, a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) that have contracted with vision care networks to provide certain eye care services.
Indemnity Plans:
Offer a wider selection of vision care providers than managed-care plans. Indemnity plans pay their share of the costs for covered services only after they receive a bill (which means that you may have to pay up front and then obtain reimbursement from your insurance company).
Managed-care plans (HMO and PPO):
Typically maintain vision provider networks. Doctors participating in a network agree to perform services for patients at pre-negotiated rates and usually will submit the claim to the insurance company for you. In general, you’ll have less paperwork and lower out-of-pocket costs with a managed-care vision plan and a wider choice of doctors with an Indemnity plan.
Vision insurance may be a vision benefits package or a discount plan.
A vision benefits package will provide free eye care services and eyewear within fixed dollar amounts in exchange for an annual premium and a relatively small co-pay each time you use a service.
A discount vision plan provides eye care and eyewear at discounted rates after you pay an annual premium or membership fee.
In some cases, a vision benefits package or discount vision plan may also include a “deductible” which is a fixed dollar amount you must pay your eye care provider out-of-pocket before the insurance benefits take effect.