Benefiting You

What you need to know about vision insurance

You rely on your eyesight to work, play and understand the world around you. Your vision insurance benefits can help you protect your eyes and keep them healthy — but only if you understand your vision plan clearly. Do you know what you need to know about vision insurance?

“It’s important for people to understand vision benefits because the coverage can be very confusing and not all plans are the same,” said optometrist Dr. Gina Lippi. “Often, it’s relatively inexpensive to add vision benefits to your existing insurance, but unless you’re aware of the potential limitations of that coverage, it may not be very useful.”

Here are three key things to know about vision insurance:

Vision insurance includes routine eye exams.
You may hear the term “vision insurance” while at the ophthalmologist’s office, but the term is often used to describe what’s actually a discount vision plan. These plans are similar to other wellness benefits and provide discounted preventive and screening services to help keep your eyes healthy.

“Vision insurance will cover routine eye exams and usually have benefits that help pay for the purchase of eyeglasses and contact lenses,” Lippi said.

Eye exams usually include the following:
• A review of your health history.
• A measurement of your eyesight.
• Tests regarding depth perception, color vision and how your pupils react to light.
• A measurement of the curve of your cornea.
• Determination of how your eyes focus together.
• Screenings for eye health.

Vision insurance provides eyeglasses benefits.
No matter which frames you pick, eyewear can be expensive. Features such as special coatings or safety frames can add to the cost.

“To get the most out of your vision insurance, you need to understand your visual needs,” Lippi said. “Will you be wearing glasses or contacts full time? Will you need bifocals? Is your prescription changing every year? Every plan is different and you want to be sure your plan will cover your needs.”

One of the biggest benefits of having a vision plan is the discounts you can get on eyewear purchases and coverage for those purchases. But be careful of the limitations some vision plans may have, Lippi said. Some plans offer significant coverage or allowances for eyewear and may allow you to choose and apply your full benefit to any frames. Others may offer only small discounts.

“Some optical shops may offer greater discounts and offer products of better quality than the vision insurance will allow,” Lippi said.

Vision insurance is different from medical insurance.
Vision benefits can be confusing because patients may believe the screenings are provided under a health care benefit. This can be compounded by talk of “in-network” and “out-of-network” providers and the fact that you’re seeing an eye doctor for your exam. But understanding what your benefits will and won’t cover is key to getting the most out of them.

“Vision insurance will not cover any secondary procedures or exams that have a medical diagnosis,” Lippi said. That means even if your optometrist or ophthalmologist diagnoses a medical issue, you’ll have to rely on your health insurance to cover any treatments.

On the flip side, many medical insurance plans will cover a routine eye exam, but won’t offer the added benefits toward discounted eyewear, Lippi said. Reviewing your policy regularly and contacting customer service if you have questions can help you stay informed about your benefits.

This post is based on content that first appeared in SmileInSight.

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