Understanding vision plans and coverage
The options available to you in vision plans can be a little daunting. If you’ve chosen your vision plan through your employer, your HR department and the provider company literature—and websites—are a good place to start to understand what your vision plan does and does not cover.
In general, there are two types of vision insurance plans:
Vision Benefits Package
Vision Discount Plans
While similar to traditional vision benefits, this type of vision plan is generally less flexible than a vision benefits package because it offers flat “discounts” across the board for a wide menu of vision-related services, including specified discounts on eye exams, eyeglasses and contact lenses, even many surgical procedures.
You agree to pay the difference in cost in full—however these types of plans generally offer lower premiums than traditional vision benefit plans.
A vision plan like this typically includes a “network” of participating eyecare professionals who have agreed to honor the stated discounts within the vision plan, so long as you agree to pay the difference.
Vision Insurance Planning
It may sound confusing at first, but you can “plan” to use your vision plan to your maximum benefit by fully understanding what is specifically covered or not covered under your vision plan, and by also discussing options with your eyecare professional to see how best to apply your particular vision coverage to your eyecare expenses.
This planning includes fully understanding any “traditional” health insurance coverage you may have. Unexpected eye injury, or the onset of certain eye diseases and their related treatments is often covered by your traditional health insurance rather than your specific vision benefits plan.
The point here is—it’s your vision plan, your vision coverage—understanding your particular vision insurance plan is critical to maximizing those benefits.
Use it or lose it. Vision insurance benefits do expire.
Depending upon the type of vision benefit plan you’ve enrolled in, your vision benefits may expire annually. This means if you don’t “use it” you “lose it” until the next year. Since in some way, shape or form, you are contributing your hard-earned money toward your vision coverage, there’s really no excuse to skip your annual eye exam, or get “checked out” should you experience any changes in your vision.
What’s more, many of the defined contribution vision insurance plans (using Flexible Spending Accounts or Health Savings Accounts, in particular) don’t allow for your deposited money to “roll over” into the next year. If you don’t spend what you’ve allocated, you may be at risk of losing that money entirely.
Think beyond the traditional examination—a second pair of eyeglasses, prescription sunglasses, photochromic lenses, or eyewear that’s specifically designed to fit your lifestyle, such as computer glasses or sports goggles. All might be within ready reach if you maximize your vision insurance coverage.
Special thanks to the National Eye Institute, National Institutes of Health, for source material that aided in the creation of this website.