We all know that health insurance is something you shouldn’t live without, but what about vision care insurance? Your ability to see is almost as important as your health. Eye care insurance can be purchased as a group benefit through your employer or as an individual policy. But how does the cost compare to the coverage you will receive with Warby Parker takes insurance?
main lesson
- Most vision care plans offer discounts on laser eye correction surgery.
- All vision care plans have different offerings – some plans only offer minimal services, others may help cover eye surgery treatments.
- Vision care plan benefits are not necessarily available every 12 months. It could be a longer period of time, like 24 months.
How does vision care insurance work?
When you have vision insurance, you send the vision insurer a check for your premium for individual plans or have the premium deducted from your paycheck for employer-sponsored plans.
In return, you will receive benefits such as discounted vision exams, glasses and contact lenses. Some vision care plans require you to consult a provider in the plan’s network. Other vision care plans simply require you to be treated by an optometrist or ophthalmologist. In other words, you should visit an eye care professional who graduated from an accredited college in optometry and is state licensed or who has gone to medical school and is certified by the American Board of Ophthalmology.
Some plans also pay if you are diagnosed with an eye disorder or if your vision is permanently impaired.
purchasing a plan
If you already have an eye doctor that you want to continue seeing, make sure their services will be covered by the plan you are considering purchasing. Whether you buy your own insurance or through an employer, expect to pay somewhere between $5 and $15 a month in premiums for an individual. To add coverage for a spouse, partner or child, you can pay slightly less per person than the individual plan rate.
If your employer offers vision care insurance, you may only have one opportunity per year to apply during the annual open enrollment period. Be aware that some individual plans charge a one-time subscription fee in addition to a monthly premium.
Whether you get your coverage individually or through work, compare the total annual cost of the policy to your anticipated annual eye care expenses. You don’t want to pay more than you expect to receive.
Vision care insurance and covered expenses
Each plan covers a different set of expenses. Before signing up for any plan, make sure it covers everything you expect to need. Basic plans usually only cover eye exams, contact lenses, and eyeglasses, and may work more like discount plans than insurance.
More comprehensive plans don’t stop at exams and vision correction, they also help with eye surgery costs, eye diseases (eg, diabetic retinopathy, retinal detachment, retinitis pigmentosa, cataract, glaucoma, macular degeneration) and permanent visual impairment.
The amount of eye-related expenses that a vision care plan will cover differs significantly from plan to plan. One plan may charge a $10 copay for an eye exam and cover the difference. Another plan might pay $35 of your exam and expect you to pay the rest. Also, if a plan offers coverage for eye surgery or permanent vision loss, it may not be anything like the coverage you’re used to getting from health insurance.
Example of eye care insurance
For example, if you need eye surgery for glaucoma (a disease of the optic nerve that gradually causes blindness), you will not pay a $200 annual deductible for the procedure and the rest will be covered by vision insurance. Instead, your insurance may simply give you a lump sum payment of $1,000 for the surgery and leave the rest up to you.
This system may seem petty, but it has a silver lining – by placing greater responsibility on patients to cover their costs and looking for the best value, insurers can charge their customers lower premiums.
Limitations of the vision care insurance plan
We have already mentioned some of the limitations of eye care insurance. Here are some additional factors to consider when deciding whether to purchase coverage:
- The plan may cover eyeglass lenses, but only basic lenses. If you want lightweight or anti-glare lenses, you will pay all extra costs.
- The plan can cover frames, but only up to a certain amount, so if you want a $250 pair of frames, only part of your cost will be covered. Or the plan may cover the retail markup of the frames and require you to pay the wholesale cost.
- Some plans only cover eyeglasses or contact lenses, but not both, during the same benefit period. If you wanted to upgrade your contact lenses and your eyeglasses, you would have to get contact lenses a year, then take another eye exam and choose the eyeglass benefit 12 or 24 months later.
- Some plans have waiting periods ranging from 30 days to 36 months. During the waiting period, you will receive reduced benefits or no benefits. The purpose of the waiting period is to prevent people from waiting until they have an expensive problem to sign up for vision care insurance. The way insurers can pay benefits when people need them is by spreading the risk across a large group of people, some of whom are healthy and some of whom are not, and all of whom will have problems at different times. Insurers need the premiums of healthy people to pay the expenses of unhealthy people.
- Fortunately, unlike health insurance, having a pre-existing condition will not prevent you from getting vision insurance. Unfortunately, the pre-existing condition itself may not be covered.
Alternatives to eye care insurance
If vision care insurance seems too complicated, you think you don’t really need it, or you’re not sure if it’s going to be worth it, it’s okay to skip it. Unlike skipping health insurance, skipping vision insurance is not likely to land you in bankruptcy court or put your life at risk.
There are several ways to get a discount on vision care without purchasing vision care insurance. Big retailers like Costco and Walmart have optical centers in some of their stores. The centers offer examinations by licensed optometrists and sell reasonably priced eyeglasses and contact lenses. Exam costs vary by location because the optometrists who serve them are independent of the dealers. Walmart lets you look at the boards and their prices on their website.
If you’re not too picky about your frames, you can order a complete set of glasses from an online retailer for an incredibly cheap price. For example, like $6.95 for lenses and frames with $5.95 of sound shipping? Some online stores allow you to ship a pair of frames and they add prescription lenses. Discount contact lenses are also available online. You will still need a prescription from an eye doctor when using these online services.
The Bottom Line
Deciding whether to buy eye care insurance can be tricky, it’s not unilaterally a good or bad deal. Whether it makes sense for you to purchase a policy depends on a number of factors, such as the policy options you have to choose from, the types of vision care products and services you need, and how often you need them. To make sure you’re getting a product that will be valuable to you, do the research and math before signing up.
