The National Center for Health Statistics reports that more than 14 million Americans are visually impaired, and almost 80 percent of that group require eyeglasses or contacts. People with vision insurance are much more likely than those without vision insurance to have regular eye exams and corrective eyewear when necessary.
Vision insurance plans cover all or part of the cost for eye care, but coverage can differ significantly between companies and plans. Vision plans are relatively inexpensive, so consumers will save the most money by selecting a plan that meets their needs.
Top 6 Best Rated Vision Insurance
VSP Vision Care started in 1955 and offers vision insurance for individuals in all 50 states. They have more than 34,000 in-network providers and offer multiple plans available through employers and as stand-alone plans.
|Read 55 Reviews|
Humana offers vision insurance in more than 40 states. The publicly-traded company has its roots in skilled nursing facilities that opened in 1961. They have offered health insurance plans since the 1980s.
|Read 18 Reviews|
Vision Plan of America has been in business since 1986. They serve employers and individuals in California by offering multiple plan options and customizable choices. Their vision coverage can be combined with dental benefits.
|Read Expert Review|
Direct Vision Insurance sells insurance plans for the VSP and Eye Med networks. Their policies are underwritten by Security Life and are available in most states. The company’s website includes instant quote and chat features.
|Read Expert Review|
EyeBenefits was founded in 1987 in Arizona. The company sells memberships to a discount program for vision care services and products. EyeBenefits membership discounts are honored by select providers across the United States.
|Read Expert Review|
Aetna has been in business since the 19th century and has been publically traded since 1968. They offer vision insurance through group/employer plans, and their network includes most major retail chains.
|Read Expert Review|
What should consumers consider when shopping for vision insurance?
When selecting vision insurance several factors determine how much it will cost upfront and how much it will save consumers 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 providers. 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: Co-payments are set dollar amounts that the insured must pay for certain services. Co-insurance 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 co-payment 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 know they want a certain product should make sure it isn’t excluded before purchasing a plan.
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 who have a vision impairment. 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.
Those with coverage from an HMO or PPO must use one of the plan’s in-network providers 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 what penalty they will pay if they use a provider outside the network.
- Size of network: The larger a company’s network, the more choices insured individuals will have when selecting a healthcare provider. If consumers have a preferred doctor, they should contact the 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 provider.
- 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.
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.
All 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 may not be covered by vision insurance. Depending on the problem, illnesses and injuries to someone’s eye(s) may be covered by their health insurance.
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.
What are different types of vision insurance?
Indemnity insurance allows individuals to choose their healthcare provider and covers the same amount or percentage regardless of which provider the insured visits. Indemnity plans do not have a network of providers.
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. There is no outside coverage.
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 co-payment or co-insurance amount. The deductible for out-of-network doctors may be separate from that for in-network treatment.
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.
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.
Individuals who want vision coverage but do not have vision benefits from their employer or who do not want to use their employers’ plan may independently purchase vision insurance from a variety of companies. Stand-alone plans might be an indemnity policy, a PPO or an HMO.
Who should shop for vision insurance?
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.
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.
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.
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.
Anyone whose job requires them to drive should regularly have their vision tested. Professional drivers may wish to choose a plan that includes prescription sunglasses.
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.
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.
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.
VSP Vision was founded in 1955 by optometrists in California. In the 1980s, VSP became available throughout the United States, and today the company provides vision coverage to over 80 million members.
- Best for VSP is best for retirees, individuals, families and anyone who wishes to give eye coverage to someone else.
Humana is a health insurance company with headquarters in Louisville, Ky. The company was founded in 1961 as a nursing home group and began offering health plans in the mid-1980s. It is now a publicly traded company.
- Best for Humana is best for anyone looking to purchase a stand-alone vision plan.
Aetna was established in 1853 and began offering health insurance policies to life insurance customers in 1899. They have been publicly traded on the New York Stock Exchange since the late-1960s. Aetna offers separate vision coverage for purchase through some employers.
- Best for Aetna Vision is best for those whose employers offer it as a benefit.
Vision Plan of America was founded in 1986 and offers insurance coverage to those living in California. They have plans that are associated with employers and ones for the general public to purchase.
- Best for Vision Plan of America is best for individuals and business owners in California.
Direct Vision Insurance offers stand-alone plans in 41 states. The company is a part of Direct Benefits, Inc. Their providers are in either the VSP network or the EyeMed network and are underwritten by Security Life.
- Best for Direct Vision Insurance is good for individuals looking for stand-alone plans as well as insurance agents and brokers.
EyeBenefits is a vision discount program that started in 1987 in Scottsdale, Ariz. The company sells memberships to individuals and to companies, who can offer membership as an added benefit for their employees. Members receive a preset discount on services and products when they use an EyeBenefits’ provider.
- Best for EyeBenefits is best for individuals looking to supplement their vision insurance and those who do not want a monthly bill as well as business decision makers who want to add to their benefits package.
Information in this guide is general in nature and is intended for informational purposes only; it is not legal, health, investment or tax advice. ConsumerAffairs.com makes no representation as to the accuracy of the information provided and assumes no liability for any damages or loss arising from its use.