Part 1: What is Vision Insurance, What’s Covered & Not Covered, Types of Vision Insurance
Part 2: Why is Vision Insurance Important, Where to Buy, The Cost, Things to Keep in Mind, Should You Have Vision Insurance
Introduction to Vision Insurance for Kids and Teens
This video explains the concept of vision insurance in a simple, concise way for kids and beginners. It could be used by kids & teens to learn about vision insurance, or used as a money & personal finance resource by parents and teachers as part of a Financial Literacy course or K-12 curriculum.
Suitable for students from grade levels:
- Kindergarten
- Elementary School
- Middle School
- High School
The topics covered are:
- What is vision insurance
- How does vision insurance work
- What’s usually not covered in vision insurance
- What are the types of vision insurance
- Why is vision insurance important
- Where to buy vision insurance and it’s cost
- What to keep in mind when choosing a vision insurance plan
- Should you have vision insurance
What is vision insurance?
Vision insurance is a contract with an insurance provider that reduces the cost of eye care in exchange for regular premiums.
It usually covers at least a part of the cost of routine eye exams, prescription glasses and contact lenses.
Sometimes it also offers discounts on more advanced procedures such as LASIK. But the exact coverage varies based on the policy.
Vision insurance is usually not included in regular health insurance, although it might be an optional add-on.
How does vision insurance work?
You pay the insurance provider regular premiums in exchange for them sharing the costs of eye care. In addition, you may have to pay deductibles, copays, or coinsurance.
Deductible is the minimum amount you need to pay before insurance kicks-in. For instance, if the deductible is $100 and the eye doctor visit costs $80, insurance will not pay anything.
After the deductible is met, you may have to pay a percentage of the covered procedure, which is called co-insurance. This can range anywhere from 20% to 80%.
Or you may have to pay a fixed dollar amount, called copay.
The rest is paid by the insurance provider up to a predetermined allowance or annual maximum amount. Vision plans either have copay or coinsurance – not both.
What’s usually not covered in vision insurance?
Vision insurance policies can have different limitations. For example, not more than one eye exam per year or new glasses every two years.
Vision insurance plans also usually have annual benefit limits, called allowance, meaning the plan will only pay up to that amount each year.
Also, some plans have waiting periods, where you have to be enrolled in the plan for a certain amount of time before coverage begins.
Most policies do not cover cosmetic procedures like LASIK or only offer a small discount like 15%.
But the biggest exclusion is any major medical treatment or surgery for conditions like vision loss, infections, eye disease, etc. These are usually covered by health insurance.
What are the types of vision insurance?
There are two main types:
- Vision Benefits Packages provide coverage for specific services like annual eye exams and an allowance for glasses or contact lenses. If the cost of the product exceeds the allowance, you pay the difference. They could be offered as HMO plans or PPO plans.
- Health Maintenance Organization (HMO) Plans have lower premiums and out-of-pocket costs, but offer less flexibility. You are required to only visit in-network doctors, and services outside the network are usually not covered.
- Preferred Provider Organization (PPO) Plans typically have higher premiums and out-of-pocket costs as compared to HMO plans, but offer more flexibility. You can use in-network doctors who charge lower fees, or go outside the network and pay more.]
- Vision Discount Plans have lower premiums than the vision benefits packages, but are generally less flexible. They provide a flat discount on eye exams and corrective eyewear.
Why is vision insurance important?
Vision care can be expensive, and having insurance can save you money by covering at least a part of the cost.
It usually covers eye exams and provides allowance towards prescription glasses or contact lenses. The yearly allowance works like a gift card by covering the cost of basic eyewear or making premium eyewear a lot more affordable.
Maintaining good eye health is important and by getting routine exams that are covered by vision insurance, you are more likely to detect problems before they become serious.
Where can I buy vision insurance? And how much does it cost?
Many employers offer vision insurance, where the premium is deducted from your paycheck.
If your employer doesn’t offer it, you can obtain individual or family vision insurance directly from insurance companies or insurance brokers. But vision insurance is usually less expensive when bought through your employer.
Depending on your age, location and the plan you choose, the premium can range from $5 to $30 per month for one person.
The premium per person is lower if multiple family members are covered under the same vision plan. The premium is also lower in plans with higher deductible, copays and coinsurance and vice versa.
What should I keep in mind when choosing a vision insurance plan?
When choosing a plan, you first need to know what services you use and how much they cost.
For example, if you have poor vision, how much do you spend on glasses or contact lenses? This can help inform what type of policy to buy.
When comparing policies, it’s essential to look at what is covered, the network of providers offered and whether your preferred provider is in the network, the monthly premium and deductible, and limits on benefits.
Should I have vision insurance?
That depends on your personal situation – eye health, frequency of eye exams, and the need for glasses or contacts for you or your family members.
If you spend a significant amount on vision care and can find an inexpensive plan, vision insurance will likely save you money.
But if your vision is fine and you only need routine eye exams once every few years, and have no family history of vision problems, you might be better off just paying out of pocket when necessary.
Since expensive treatment of eye diseases or eye surgeries are typically covered by health insurance, you don’t have to worry about not having vision insurance for unexpected vision issues.