Vision Insurance – A Definition

The cost of regularly-scheduled eye exams and prescription eyewear is a budgetary concern of most families. Many people are not aware that vision insurance is able to lower annual expenses connected to vision care. Don’t be confused, a vision insurance policy is not the same as health insurance. Annual health insurance plans protect against financial losses due to unexpected eye injuries or disease. Vision insurance is a wellness benefit designed to provide routine eye care, prescription eyewear, and other vision related services at a reduced cost.

Where can I get vision insurance?

Group vision insurance can be obtained through your company, association, school district, etc., or through a government program such as Medicare or Medicaid. Did you know that individuals have the option to purchase their own vision benefit plan?

Vision insurance is often a value-added benefit included in indemnity health insurance plans, health maintenance organization (HMO) plans, and plans offered by preferred provider organizations (PPOs):

  • Indemnity health insurance is traditional insurance, which allows policyholders to access medical providers of their choice.
  • An HMO is a group of healthcare professionals (doctors, laboratories, and hospitals) employed to provide health care services to plan members at discounted rates. Usually, health plan members are required to access health care only from HMO providers.
  • A PPO is a network of healthcare professionals organized to provide healthcare services to plan members at a fixed rate below "retail" prices. Plan members may opt to access out-of-network providers, usually at an increased cost.

What kinds of vision insurance plans are available?

Vision insurance typically comes in the form of either a vision benefits package or a discount vision plan. Typically, a vision benefits package provides enrollees eye care services in exchange for an annual premium or membership fee, a yearly deductible for each member and a co-pay each time a member uses the service. Be aware that discount vision plans provide eye care at fixed discounted rates after an annual premium or membership fee and a deductible are reached. Both kinds of vision insurance can be custom-designed to meet the different requirements of a wide range of customers, including school districts, unions, and companies of virtually any size.

 

What does vision insurance cover?

Vision insurance generally covers the following services and products:

  • Contact lenses
  • Eyeglass lenses
  • Eyeglass frames
  • Annual eye examinations
  • LASIK and PRK vision correction at discounted rates

Generally, services acquired from network providers are less expensive than services from out-of-network providers.

 

What are my payment options?

Usually, if group vision insurance is available from your employer, you pay for the plan through payroll deductions or flexible spending accounts (FSAs). An FSA, sometimes called a cafeteria plan, allows an employee to use pre-tax dollars to purchase selected health benefits such as vision insurance. You save money because you receive the full benefit of income that has been set aside for health costs, making it not subject to or reduced by taxation. When an individual vision insurance plan is purchased the individual can expect to be billed monthly or annually.