What Does Vision Insurance Pay For?

Whether your employer is offering vision insurance, or if you are interested in vision insurance on an individual basis, you are probably wondering if you need Vision Insurance or not. To answer that, there are a few questions we need to address. The questions we want to ask today is, What Does Vision Insurance Pay For, or What Types of Services Fall under Vision Insurance?

First, lets discuss what Vision Insurance does pay for: Vision Insurance will cover a routine eye exam annually. A routine eye exam can be defined as an exam of a normal, healthy pair of eyes with no issues or abnormalities. A routine eye exam includes eyes with routine issues such as nearsightedness(myopia), farsightedness(hyperopia), people that are having issues seeing at intermediate distances(presbyopia) and astigmatism(which is when the cornea is not perfectly round).

Vision Insurance usually provides benefits for glasses, contacts lenses and also may help pay for the services required to fit a person for contacts, and evaluate their qualifications to wear contacts annually. The benefits for glasses are either a combined benefit with a maximum dollar amount, or there are separate benefits for frame and lenses. A Vision Plan may also discount lens treatments such as Transitions, anti-glare coatings, polarization(sunglass lenses that cut glare), or alternate lens materials to make lenses thinner and lighter. Vision Insurances rarely cover both contact lenses and glasses within the same benefit period; rather it is an "either, or" situation.

Now, Vision Insurance does not cover the following situations: medical eye exams, which includes, but is not limited to conditions such as diabetes, hypertension, glaucoma, macular degeneration and cataracts. If you are diagnosed with any of these diseases, vision insurance may not cover your annual eye exam. The cost will instead be applied to your medical insurance, because they are medical conditions that affect your eyes. Another more common reason to file an eye exam on your medical insurance is dry eye syndrome.

Any tests that are done to further examine your eyes due to the possibility of medical eye issues are not covered under Vision Insurance. Examples of these tests are fundus photos(photos of the inside of the eye), OCTs(Ocular Coherence Tomography, which scans the inside of the eye and produces very detailed read-outs), Visual Fields(testing your vision in different quadrants), and pachymetry(which measures corneal thickness).

Vision Insurance is also not meant for surgeries like Lasik, or surgery to remove cataracts. Cataract surgery will fall under medical insurance. Another important thing to know is that, if you go to an eye doctor for treatment for pink eye, a feeling like there is something in your eye, or any other eye injury, these services will also fall under your medical insurance.

In conclusion, Vision Insurance will cover an eye exam if you do not have any underlying medical conditions that affect your eyes. A Vision Plan will help cover the cost of glasses or contact lenses, whether you have healthy eyes or not. Even if you can't file your eye exam on your Vision Plan, you will still be able to file the cost of your eyewear, so do not write off the idea of purchasing Vision Insurance just because you are a diabetic. It can still save you hundreds of dollars on eyewear. In a future article, we will address how the cost of Vision Insurance compares to the cost of covered services.

If you have questions about vision insurance, please contact us at KeepYourEyesCovered.com