Best Vision Insurance Companies

Price

When selecting vision insurance several factors determine how much it will cost upfront and how much it will save in the long run. Consumers should compare the amount they will spend on the policy to their estimated eye care cost without insurance to ensure that they will financially benefit by purchasing vision insurance.

• Premium: The premium is the monthly or yearly fee a consumer must pay to be covered by insurance and/or have access to discounted rates from participating eye care specialists. Customers must pay their premiums whether or not they use the coverage throughout the year.
• Deductible: The deductible is the amount that the insured party must pay, usually each year, before the insurance company pays for services. Some services may not be subject to the deductible. For example, a yearly exam may be included for no additional out-of-pocket cost.
• Co-payments/co-insurance: Copayments are set dollar amounts that the insured must pay for certain services. Coinsurance is a set percentage of the final cost that the insured person must pay. For example, a visit to a specialist might require the insured to make a $20 copayment or pay 20 percent of the office visit cost.
• Exclusions: The insurance may exclude certain items, meaning the insured would have to pay for the total cost of the treatment. Consumers who want an eye care product or need a specific procedure should make sure it isn’t excluded before purchasing a vision plan.

Covered items

Different plans will have different coverage details. Usually, plans with more comprehensive coverage will have a higher premium, so consumers should realistically assess their needs before purchasing/selecting a plan.

• Eye exams: All vision insurance plans will include a free or discounted basic eye exam. However, the allowed frequency of free/discounted exams can vary between plans. Usually, plans cover one eye exam per year.
• Glasses/Contacts: Plans usually cover one pair of eyeglasses or a one-year supply of contact lenses for individuals with impaired vision. Consumers who know they want contacts instead of glasses should make sure the plan they purchase allows them to make that choice.
• Allowances: Many plans have a set amount allowed to cover eyeglasses or contacts. Insured individuals are responsible for any cost over than allowance. Consumers should consider the allowance when calculating how much they can save by purchasing vision coverage.

Providers/network

Those with coverage from an HMO or PPO must use one of the plan’s in-network providers of eye care services for the insurance company to pay the largest portion of the cost. Consumers should be aware of how many in-network providers practice in their area and how much more they will pay if they use a provider outside the network.

• Size of network: The larger an insurance company’s network, the more choices insured individuals will have when selecting a vision care provider. Consumers should contact their doctor’s office to find out what networks the doctor belongs to before purchasing insurance.
• Out-of-network coverage: Consumers should understand what their insurance plan will pay if they visit an out-of-network eye specialist.
• Retailers: Some contact and eyeglass retailers work with specific vision insurance companies. Consumers may find it easier and/or cheaper to purchase eyewear from an in-network retailer.

Coverage period

The coverage period is the time frame during which the insurance will pay for the designated part of customers’ vision expenses.

• Enrollment: Consumers who obtain vision insurance through their employer can usually only enroll in a new plan during their company’s open enrollment period. Those purchasing stand-alone plans can typically do so at any time during the year.
• Wait time: Different policies will take effect at different times. Many stand-alone policies are effective as soon as the paperwork is processed and the first premium is paid. Employer provided plans may only go into effect after open enrollment ends or the employee has been employed a certain number of days.
• Cancelation: Different plans have different coverage terms, but most companies have one-year terms. Some stand-alone plans offer discounts for paying premiums annually, and some may let customers cancel plans early.

Limitations

All vision plans will have limitations on the items that they will pay for. Consumers should determine whether the services they need are covered by the plan.

• LASIK: Most vision plans will not fully cover LASIK. However, they usually offer discounts on the procedure and/or have a network of LASIK providers that offer special deals for people with specific insurance plans.
• Specialty lenses: Plans may or may not cover special lenses like unlined bifocals, photochromic lenses and/or prescription sunglasses.
• Specialists: Visits to specialists and treatment beyond simply correcting vision problems – cataract surgery, for instance – isn’t likely to be covered by vision insurance. Depending on the problem, illnesses and injuries to someone’s eye(s) may be covered by their primary health insurance.

Essential coverage

Under the Affordable Care Act (ACA), health insurance plans must cover essential care, called an Essential Health Benefit (EHB).

• Children: Vision coverage is considered essential for those under 18, so pediatric health insurance plans must cover at least some of the cost of eye exams and corrective glasses or contacts. Plans sold on healthcare.gov for children automatically include vision coverage.
• Adults: Vision coverage is not an EHB for adults, so most adult health insurance plans do not cover routine eye care and glasses/contacts. Tax credits cannot be used to purchase stand-alone vision care, meaning that individuals whose employers do not offer vision benefits must pay the entire premium themselves if they wish to purchase coverage. The ACA does not require adults to have vision insurance.

Indemnity insurance

Indemnity insurance allows individuals to choose their healthcare provider and covers the same amount or percentage for services regardless of which provider the insured visits. Indemnity plans do not have a network of providers.

HMO Plans

Health Maintenance Organizations are groups of providers who offer discounted rates to those who have a health plan with their group. HMOs will only pay for care received from providers who participate in the plan.

PPO Plans

Preferred Provider Organizations are groups of providers who offer discounted rates to those who have a plan with their group. Individuals with a PPO can visit providers who do not participate in the PPO, but they will be required to pay a higher copayment or coinsurance amount. The deductible for out-of-network doctors may be separate from that for in-network treatment.

Discount programs

Discount programs are not the same as insurance policies. Discount programs are usually sold as annual memberships that give members special discounts from certain providers. The government does not regulate these programs the same way as insurance policies.

Employer provided

Some employers offer vision insurance as part of their benefits package, usually paying a portion of the monthly premium for the employee. Employees do not have to enroll in their company’s vision plan. Employer plans might be an indemnity policy, a PPO or an HMO.

Stand-alone plans

Individuals who want vision coverage but do not have vision benefits from their employer or who do not want to use their employer’s plan may independently purchase vision insurance from a variety of companies. Stand-alone plans might be an indemnity policy, a PPO or an HMO.

Employees

Anyone whose employer offers vision insurance as part of their benefits package should compare all the options provided by their employer as well as stand-alone plans they could purchase on their own. Coverage through their employer will likely be cheaper than stand-alone insurance, but it may not meet all their needs.

Individuals

Anyone who does not have the option to purchase vision coverage through their employer should shop for stand-alone insurance. Those who plan to have an eye exam in the near future should consider purchasing a stand-alone plan with a short waiting period.

Parents

Eye care is an essential benefit for minor children, but parents of young adults may wish to purchase stand-alone products for the young adults in their lives. Some companies sell vision insurance gift packages. Children and toddlers between the ages of 3 and 6 should have their first comprehensive eye exam so optometrists can identify problems early.

College students

Students who spend a great deal of time studying should regularly have their eyes examined. This group should make sure the plan they choose has a large enough frame allowance to purchase frames they like and/or the option to purchase contacts instead of eyeglasses.

Professionals

Anyone whose job requires them to drive or fly should regularly have their vision tested. Professional drivers, train engineers or pilots may wish to choose a plan that includes prescription sunglasses.

Diabetics

Anyone who suffers from diabetes should have their eye health assessed regularly and should consider purchasing vision insurance to defray the expense. Diabetes is a leading cause of blindness in people under retirement age.

Retirees

Seniors should have regular eye exams. Depending on their health insurance coverage, they might want to consider plans that cover visits to specialists, including those who treat glaucoma and cataracts. Medicare generally doesn’t cover eyeglasses and contact lenses.

Business decision makers

Individuals who make decisions about a business’ benefit package should explore the cost of providing vision insurance to employees. More extensive benefit packages help attract and retain qualified employees.