Getting a comprehensive eye exam and new frames and lenses can mean some serious sticker shock: Health insurance policies generally cover eye care only if you’ve got a medical issue. So many Americans seek to soften the cost by signing up for vision plans, either through their employers or on their own.
Here are nine things to keep in mind when you consider what type of plan — or no plan at all — is best for you.
1. There are two basic types of plans. Vision benefits packages give you access to a fixed dollar amount of services for a premium or a membership fee. Discount vision plans simply give you a predefined discount, such as 20 percent off covered services, to whatever level of spending you want.
2. Benefits packages function like health insurance. You might have a co-pay of $10 to $25, and the plan typically limits what it will shell out for specific products or services. For example, the plan might provide for a fixed dollar amount toward a pair of frames and require you to pay the difference if you choose a more expensive pair. Elective services such as LASIK eye surgery are typically not covered.
3. Benefits packages tend to charge you more than discount plans. According to AllAboutVision.com, a website that provides eye health information, a typical annual premium for a benefits package for an individual is $170.95 compared with $69.50 for a discount vision plan.
4. If you aren’t planning to get new glasses or don’t make use of many vision services each year, a discount plan may be the best route, says Mary Carder, president of EyeBenefits, a discount plan provider based in Scottsdale, Ariz.
5. Vision benefits packages can give you peace of mind in knowing that if the costs of your eye care soar beyond your expectations, you’re still covered. Just remember: You’ll be paying a fixed amount in premiums whether you use the plan’s full value of services or not.
6. When considering either type of plan, try to calculate what it would cost you to pay the entire bill yourself. Then compare that with the plans’ cost of premiums plus the out-of-pocket costs you’d have to cover.
7. Other factors to keep in mind for either type of plan is whether it covers services by a favorite optometrist and whether the locations for services in general are convenient. To avoid unpleasant shocks, you should also find out what’s not included in a plan before signing up.
8. If you don’t have a vision plan, some eye doctors will make financial arrangements if you’re facing financial hardship.
9. Americans who take part in vision insurance plans are twice as likely to schedule an eye exam as those who don’t, according to the National Association of Vision Care Plans. That can be crucial for your health in general. “A very thorough eye exam will catch eye disease and discover health issues you may not have known you have, such as high blood pressure, diabetes, even brain tumors,” says Burt Dubow, an optometrist at Insight Eye Care in St. Cloud, Minn.