Does Health Insurance Cover Eye Exams?
If you get regular eye check-ups, need reading glasses, or wear contact lenses, you know that eye exams can be quite expensive. So it is important to know what kind of vision coverage is available to you. Good vision coverage can significantly lower your eye care and prescription eyewear costs.
Vision coverage varies from plan to plan. While some large group health insurance plans might offer you vision coverage, most private health insurance plans do not automatically cover you for vision concerns such as eye exams.
If your present health insurance plan does not cover you for eye exams, you could get additional coverage through an add-on vision insurance plan. This will give you access to standard eye exams and discounts on eyeglasses and contact lenses, as well as other eye care options. If you need regular eye care, this might be a viable option.
What is Vision or Eye Care Insurance?
As the name indicates, vision insurance is a form of supplemental health insurance that covers you for specific and defined benefits towards your eye care. These benefits, as well as other related terms and conditions, are mentioned in your policy.
Typical eye care insurance policies will cover the policyholders for routine annual eye exams and procedures such as cataract removal, among others. Depending on the policy, you are allowed access to a range of network providers that could include: ophthalmologists, optometrists, eye surgeons such as LASIK specialists, and optical labs.
You also get a set dollar amount for prescription eyewear. This includes contact lenses, eyeglass frames and lenses, and discounts towards corrective laser surgery for the eyes.
Much like health insurance, your vision insurance policy will supply you with a list of pre-approved network providers. Generally, going out of network for any services will be more expensive that staying within the network.
Do I need Vision Insurance?
Routine eye exams and prescription eye wear such as contact lenses can be very expensive. So if you need regular eye care, it might make sense to get vision coverage.
Most standard employee-based and private health insurance plans cover patients for catastrophic eye injuries, as well as unexpected eye diseases even without vision insurance. However, vision insurance is designed as a wellness benefits package that is meant to lower personal costs for preventive procedures such as routine eye exams and eye wear.
So it makes good sense to explore all your vision options such as the provisions available under your present health insurance policy, which might extend some coverage for eye care. If not, getting additional vision coverage might be a sensible decision, more so if you have a large family.
What are the different forms of vision insurance?
Vision insurance can be available through multiple channels. It can be a part of your traditional health insurance plan, an add-on vision benefits package, or a discount eye care plan. When vision coverage is a part of your traditional health insurance package, you have to meet all the terms of monthly or yearly premiums, co-pays, and deductibles, as defined under your policy.
Another option is a vision benefits package. Under such plans, patients are allowed access to free eye care and prescription eyewear that is limited to a pre-determined dollar amount. Anything above that amount has to be covered by the policyholder. Such plans require a set membership fee or annual premium, as well as a fixed co-pay per service.
The third avenue for vision coverage is a discount vision plan. In exchange for a yearly membership fee, plan holders get a discount for eye care services and prescription eyewear including contact lenses.
Depending on the insurance company providing vision coverage, the vision benefits package and the discount vision plans might require the policyholders to pay a fixed deductible amount before the coverage comes into play.
How can I buy Vision Insurance?
Vision insurance can be accessed through a variety of channels. In many situations, vision insurance can save policyholders thousands of dollars. Make sure you take the time to read your insurance policy so as to understand your vision insurance provisions.
Group insurance policy with vision coverage may be available through your employer or through government programs such as Medicare or Medicaid.
Self-employed individuals can purchase separate insurance plans that provide vision coverage. Whether you go through an HMO or a PPO, you are likely to get a discounted or low fixed rate for care that will save you a pretty penny.
Most reputable insurance companies provide all the needed information on their websites. They usually also provide avenues through which consumers can ask questions and register complaints, if required. Make sure that the company you choose provides easy access to such platforms.
Given the multiple options available, it is very important that you do some thorough research. Before signing on for any plans, make sure that you read the fine print.