What does vision insurance cover?

Vision insurance typically covers an annual eye exam plus an allowance or copay for glasses and contacts - and it usually costs less per month than a single pair of lenses. Insurers offer different coverage levels (standard, basic, enhanced, advanced), but as a rule every vision plan includes some level of coverage for the following:

• Eye exam: one vision exam per year, with a $10-$20 copay for most insurers
• Eyeglass frames: usually an allowance, commonly $130-$150, once per year
• Eyeglass lenses: covered after a copay, typically $20-$30, once per year
• Contact lenses: either a copay or an allowance
• LASIK surgery: most insurers offer a discount on corrective surgery - amounts vary, but around $500 is common

Lens enhancements are offered at a discounted rate, including:

• Scratch-resistant coating
• Anti-glare coating
• Polycarbonate lenses (stronger, thinner lenses)
• Transition lenses, which darken into sunglasses in daylight
• Progressive lenses (no-line bifocals)

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What Doesn't Vision Insurance Cover?

Just like any insurance policy, there are certain things vision insurance won't cover, and it varies by company. Ask about limitations and exclusions before you enroll. Common exclusions:

• Additional exams beyond the one per year
• Replacement of damaged or lost glasses, unless a warranty option is purchased
• Missed appointment charges, application fees, or other miscellaneous charges
• Non-prescription glasses, like magnification reading glasses
• Medical treatment of the eye - injuries, surgeries, and disease treatment fall under your health insurance policy
• Experimental or investigative procedures
• Treatment where the doctor is a member of your family

Note: If you have children under age 19 with marketplace health insurance, their vision care is already covered - that's an Affordable Care Act mandate.

Can You Recommend Some Plans?

Yes - we're happy to help. Two highly rated networks stand out for individuals and families shopping the open market:

VSP

The VSP Choice Network offers more than 70,000 access points at nearly 23,000 independent locations, plus 16,000 retail chain access points at nearly 8,000 retail locations. When you use an in-network provider, extra discounts stack on top of your plan benefits:

• 20% off your remaining frame balance
• 20% off non-covered complete prescription glasses
• 20-25% off non-covered lens options such as UV coating and polycarbonate lenses
• 15% average off retail for LASIK or PRK laser eye correction (or 5% off promotional pricing) through a VSP provider

EyeMed

EyeMed earned strong customer satisfaction marks from J.D. Power, and EyeMed vision insurance is accepted at tens of thousands of independent and retail providers, including LensCrafters, Pearle Vision, and Target Optical. Where most insurers offer 20% off a second pair of glasses within the policy year, EyeMed offers 40%. EyeMed is also a proud supporter of OneSight, a nonprofit providing vision care in underserved communities worldwide.

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Questions first? Call (312) 726-6565 or email help@ihealthagents.com.

Based on applicable laws, reduced costs may vary by doctor location. Coverage details and discounts are set by the carriers and subject to change.