Vision Insurance

Many people have problems with their vision in today's world. Regular eye-check-ups are important for both adults and children. Having vision insurance is important so that you can save money on eye service, exams, glasses, and more.


1. Definition of Vision Insurance

Having vision coverage can help with the high costs of eye exams and prescription eyewear. Vision insurance is basically a "wellness" benefit used for preventive eye care services, regular eye exams, and eyewear. Eyewear that is typically covered is glasses, frames, and contact lenses. Vision coverage does not cover a person who has an accident or disease concerning his or her eye. That would be covered by regular health insurance plans. Having vision insurance is important, especially if eye and sight problems run in the family.

Vision coverage may be obtained in a couple different ways. Many companies offer their employees an eye plan along with regular health benefits. Government programs such as Medicare or Medicaid can help people over the age of 65, or those who are disabled, to qualify for vision insurance. A vision plan may also be purchased on an individual basis through private companies. HMO's, or health maintenance organizations, and PPO's, or preferred provider organizations, may link their own vision insurance plan through their health insurance plans as an added benefit.

The following benefits will be received with vision insurance: The ability to see a number of providers, which will include optometrists and ophthalmologists, as well as access to preventive eye care services at a lower rate.

2. Types of Vision Insurance Plans

There are usually two main types of vision insurance plans. Vision benefits packages or discount vision plans are the two types of plans offered to the public. Vision benefits packages usually offer those who enroll in services on eye care as long as an annual premium is paid or a membership fee is paid. They may also charge a deductible every year for each person who is enrolled. A Co-pay is also typically charged each time a member of the insurance plan uses a service.

Discount vision plans give members a quality eye plan at low rates that are set at a fixed amount. These are given after a membership fee or an annual premium, along with a deductible, is paid. These two vision coverage plans can be tweaked to fit the different needs of many customers. Many of the following vision services are included with these two types of plans, including annual eye exams, frames, and lenses for eyeglasses, contact lenses, and also LASIK and PRK vision corrections that may be discounted for the plan holder. The benefits of having a vision plan can be quite worth the money spent for one to obtain it.

3. Costs of Vision Insurance

The costs of vision service and vision coverage will depend on the program you choose and how it is designed. You may expect to pay the following if you go with a vision benefits package: a membership fee or a monthly premium that can be anywhere from $0 to $12, deductibles from $0 to $35, a co-payment of $10 to $15 for each service rendered, and any out of network services that are not routinely covered. Those who choose a vision discount plan may pay: membership fees or a monthly premium that may be from $0 to $12, deductibles of $0 to $35, and a fixed price, which will always be discounted, for each service that you are provided from an eye doctor. Any expenses that are not in the vision coverage plan will not be covered, and will have to be paid out of pocket.

For those who have a vision eye plan through their employer, it is generally paid by a payroll deduction straight from your check. For those who have purchased vision insurance individually, they should plan on being either billed monthly or yearly, depending on the eye plan. It is important to review a vision service thoroughly before committing to one, as each eye plan will have differences that must be considered.

4. Vision Insurance Terms

It is very important to understand the different terms used when using vision insurance for yourself and your family. There are many different terminology words used when describing vision coverage. A network is a combination of optometrists, eyewear and contact lens manufactures, laboratories that specialize in optical services, and LASIK/PRK companies or doctors that are contracted with vision insurance plans. A PCP is also known as a primary care provider, who may be an optometrist or an ophthalmologist who a vision insurance company uses for service on people with eye care issues. POS refers to a point-of-service, specifically; an insurance plan for vision that can let their member's use eye care services from out-of-network providers, as long as they pay more for the service.

A premium is what is paid annually to keep insurance current and effective. Another term that is common in eye care insurance may be preferred provider organization, or a PPO. This is a large network of providers of healthcare that an insurance company may organize so that they may offer vision service to their eye care policyholders not only at a fixed price, but at a lower one as well. Another common term is VSP. A VSP simply stands for vision service plan, and can be used to refer to any type of vision coverage.

5. Using a Vision Coverage Plan

It is always important to know what you will be getting out of your VSP before and even after you obtain one. There are many questions that should be asked so you are aware of all the services and benefits that will be offered to you. Some of those standard questions should be as follows: What types of service does my eye plan extend to me? Where can I get service done, and from who? What are the steps to making an appointment with a provider of eye care? If I have an issue, problem, or grievance with this vision insurance, who should I contact?

There are other issues that should be reviewed as well. Some vision coverage requires having an identification card, so one may need to be obtained. Knowing if there will be a co-payment, and how much it will be, is another important factor in choosing a VSP. Knowing the amount of any deductibles that you will be responsible for is also important, especially if you need major eye care work. If your current provider is not on the eye plan list, you may want to know if your insurance provider allows still seeing that specific doctor, if you want to stay on with them. Also, find out beforehand if you can expect to get reimbursed for any service that may be performed. Staying knowledgeable about your vision insurance is very important to keeping health and vision costs low.

6. Protecting Your Vision

There are many ways to lower your vision costs as well as protect your eyes for years to come. First of all, figure out if your family has a history of eye disease. Having regular eye exams can catch problems in the beginning so that they may be taken care of quickly. There are other health problems that can actually cause vision issues if they are not treated. It is important to check for diabetes and high blood pressure, as these conditions can lead to eye problems like macular degeneration or ocular hypertension. Protect your eye sight by seeing an eye doctor at once if you have any sudden eye problems, such as double or hazy vision, eye pain, floaters, or swelling.

Studies have shown that walking and participating in regular exercise can actually reduce the risks of developing macular degeneration, so it is important for your eyes to stay in good health. Sunglasses should always be worn to protect the eyes from harmful rays, which can reduce the risk of developing cataracts in your later years. Both cataracts and macular degeneration have been linked to those who smoke, as well.

Eye problems affect one in six adults in the United States who are 45 years old and older. As the years increase, so do the risks for vision problems. Following the above advice, and especially having regular eye exams, can save your eyesight. It can also save money on your vision insurance.

7. Eye Exams and What to Expect

An eye care exam should happen every one to three years, for both children and adults, according to the eye care experts in the field. Children especially should be screened for eye care problems, especially if they are genetically at risk for them. Studies have shown that approximately one out of every 20 preschool kids and also one out of every four school-aged kids have some type of eye problem. If left untreated, it could cause permanent vision damage or even loss of vision later on. Children should be examined as early as six months if they are at risk.

Adults should expect to use their vision insurance to have en eye exam once a year, if they have glasses or contacts or eye issues. If you have no problems with your vision, it is still recommended to have regular eye exams about every one to three years to look for age-related problems. Anyone over the age of 69 should expect to have their eyes checked yearly. Risks for eye problems increase with age, and the American Optometric Association advises to keep up on eye care to weed out problems such as cataracts. Eye care is important at every age, and everyone should expect to have regular eye exams, no matter how their eyesight currently is.

8. Eye Care Professionals in your Vision Coverage

For those who use their eye plan coverage, there are three main types of eye care professionals. These are optometrists, ophthalmologists, and opticians. Knowing the difference between these three can not only help you find the right doctor for your eye care needs, but you will save money on your vision plan by going to the right place first.

An optometrist is probably the most common and well-known eye doctor in the business. They most typically perform routine eye exams and prescribe eyeglass prescriptions and contacts lenses. They usually treat medical conditions with eye drops and other prescriptions. An optometrist may have eight or even more years of training. They can also offer vision aids and vision therapy, and sometimes perform more minor surgical operations. Most vision coverage will cover visits to an optometrist.

An ophthalmologist is a medical doctor who specializes in the eye care business. They are trained to perform eye surgery and to also treat more serious conditions of the eye. You must have 12 or more years of training to specialize as an ophthalmologist. An optician is not a doctor. They can, however, repair glasses or adjust their fit, help those who have contact lenses and also grind and assemble spectacles. An optician can receive their training on the job. They can also go to a technical school to train for their job.

9. Medicare Vision Coverage

For those aged 65 years or older, or those with specific disabilities, Medicare coverage is available. There are specific types of vision insurance that is given as a service of Medicare. Those who have Medicare or Medicaid need to understand what type they have and what type of eye care is covered in your VSP. First, there is Part A, which generally covers costs that occur in a hospital or rehabilitation setting. If a vision problem, such as a traumatic eye injury occurs, Medicare Part A would cover it. Medicare Part B covers doctor visits and some services that Part A does not. Any eye diseases that a doctor could look at could be covered by your eye plan in this section of Medicare. Part D is another area of Medicare that is used for the purchase of prescription drugs. For those who have a specific eye disease, such as glaucoma, Medicare Part D would cover all prescribed eye drops or similar prescription medications.

It is highly important in today's world to have adequate vision insurance. For those who need it, talk to your employer or doctor about the best plan to get on.
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