Consumer Guide to Vision Insurance

In this page, you'll find comprehensive explanations of the different ways that companies or individuals can obtain vision benefits. You'll also learn how to compare different plans, and which ones might apply to your specific situation.

The Consumer Guide to Vision Insurance includes these topics:

What Is Vision Insurance?

Vision insurance is a type of health insurance that entitles you to specific eye care benefits defined in the policy. Vision insurance policies typically cover routine eye exams and other procedures, and provide specified dollar amounts or discounts for the purchase of eyeglasses and contact lenses. Some vision insurance policies also offer discounts on refractive surgery, such as LASIK and PRK.

Potentially high costs of routine eye examinations and prescription eyewear can be of real concern, especially for large families. You might be able to defray at least some of these costs by looking into acquiring vision insurance for yourself or better understanding the plan your company already provides.

Vision insurance only supplements regular health insurance. Regular health insurance plans protect you against financial loss due to unexpected eye injury or disease. Vision insurance, on the other hand, is a wellness benefit designed to reduce your costs for routine, preventive eye care such as eye exams, eyewear and other services.

How To Use Vision Insurance

As soon as you purchase or enroll in a vision insurance plan, obtain a copy of your plan brochure or find out how to access it online. Study the brochure carefully to determine what your benefits include, what costs are involved, and who is on your network provider list. Look also for answers to the following questions:

     *What services am I entitled to under my vision plan?
     *Who is on the network provider list?
     *How do I schedule an appointment with an eye care provider?
     *What quality assurance mechanisms are in place?
     *What is the process for settling grievances?

Using Your Vision Insurance for an Eye Exam

After you understand your benefits and know which providers you can use, you are ready to make an appointment for an eye examination. When you make your appointment, be prepared to supply the optometrist or ophthalmologist with the name of your vision insurance company, the name of the plan under which you are covered, and your I.D. number. This is because they usually need pre-authorization from your vision insurance company before they can render a service.

At the time of your appointment, you will be asked to show your vision insurance I.D. card or give some other proof of vision insurance coverage. Depending upon your vision plan, you also may be asked to pay a deductible, and/or a co-pay or discounted prices for the services you receive.

If you require a prescription for vision correction, your optometrist or ophthalmologist, who is also your primary care provider, may help you pick out eyeglasses or contact lenses if these services are available on site. Typically, the primary care provider also will arrange with a laboratory to have your eyewear prescription filled then contact you when your lenses are ready to be fitted.

If you select an out-of-network provider, you can expect to pay the full retail price for the services you want at the time of service. Typically, you must submit a request for reimbursement and an itemized copy of all your receipts to your vision insurance company to receive reimbursement.