Medical Insurance vs. Vision Care

Two Piggy Banks Square Image Insert TextThe difference between health insurance and vision insurance can be difficult to explain.

Often, this can be a confusing issue and sometimes you have to talk with a benefits specialist or if your insurance is from your employer, you may have to talk with someone from HR to find out how your coverage works, but in general vision insurance covers routine eye exams and a portion of your glasses or contact lens costs.

The covered portion is a predetermined amount.  In some cases, an eye exam and glasses or contact prescription is only covered every two years (bi-annually), in other cases, it’s every year (annually).

Health Insurance and Medical Conditions

Your health insurance covers eye care related to medical conditions. That means if you need an eye exam because of cataracts, dry eyes, complications from diabetes, high blood pressure, or because of any other eye disease, then your health care insurance will cover the exam. You do not need vision coverage for these types of eye exams. Your health insurance also covers eye care for eye injuries.

The cost of vision plans are usually inexpensive and range from $12 to $40 a month, depending on whether the plan is for individual vision coverage or family coverage.

Evaluation of Vision Plan

To evaluate if a vision plan is cost effective for you, review the plan to see what the covered amount is for the eye exam, eyeglass frames, and lenses. And, if you use them, find out how much the contact lens allowance is, and then weigh that against the amount you will pay a year in premium costs to find out if the coverage is worth the premium expense.

Eyeglass lens features such as anti-glare, impact-resistant, progressive, trifocal, or transition lenses are typically billed as “add on” and will increase the final cost of the lenses if you opt to have any of those features.

Also, vision insurance is different from a vision discount plan. A vision discount plan offers discounts on vision care and typically costs less than vision insurance. Discounts are only accepted at contracted facilities. In other words, you must go to a facility that is on the list of “contracted facilities” to get the discount.

Remember, eye exams can detect hidden medical problems, so even if you have perfect vision, you should have regular eye exams.