Not all vision insurance is created equally. Some insurance providers might boast additional niche benefits in their plans, but the monthly premiums are higher as a result. Other coverage will be quite affordable, but the included network of doctors leaves much to be desired.
Finding the right vision insurance plan that matches your specific needs often means finding the right insurance provider to buy coverage from. You’ll want to assess as many aspects of a provider as possible before deciding whether or not to sign up for their packages.
Here are a few tips to keep in mind that will help you pick a provider that covers all of your bases as affordably as possible.
Some of the criteria to consider in a vision insurance provider include the regional availability of their plans, age requirements, the duration of any waiting periods, the included network of providers, and of course, offerings.
If you are browsing the plans of more esteemed private providers (like VSP Individual Vision Plans), chances are their coverage will be available across the nation. However, some smaller providers might not support insurance for your state of residence. Always double-check to make sure you are in the right region before spending time exploring a provider’s benefits.
Age is another factor that may or may not make you eligible for a provider’s vision insurance. Some private providers specialize in vision plans for children that have more to offer than those you might find in the health insurance marketplace. Others have created individual plans for seniors or veterans. A vision insurance plan custom-tailored for your lifestyle is always a good thing to be on the lookout for.
An insurance waiting period is the amount of time it takes for a newly insured individual to have full access to their benefits. Some vision insurance plans might require weeks or even months before a full plan goes into effect. This could conflict with upcoming eye doctor appointments you already have scheduled. Don’t make the mistake of going through with a yearly eye exam or making expensive eyewear purchases when your vision insurance hasn’t kicked in yet!
A robust provider network can be more important than you think. You might find yourself on vacation in another state when your glasses suddenly break or you get something stuck in your eye. If your provider’s network isn’t expansive enough to cover the eyecare services in your location, you could be in trouble. On the other hand, you might not travel a lot and a large doctor network might not be as important to you (although it always pays to be safe rather than sorry). Assess each provider’s network and consider how it might affect you.
Last but not least, a provider’s offerings will likely play a large role in your final decision. Some providers have plans that help pay for LASIK surgery, for example, while others might allow more spending on eyewear enhancements such as progressive lenses. Maybe you’re only after a basic plan for the cost of contact lenses - or maybe you know you could use all the bells and whistles that come with advanced plans. Each provider will be different in regard to the plans they have to offer.
More benefits in a plan usually mean a higher price. Which leads us to…
Cost of Coverage
Because every provider is unique, you have a large selection of vision insurance pricing to choose from. Most providers strive to make their benefits cost-effective enough for all walks of life, but some plans are certainly more expensive than others.
One of the most important cost factors to take into account is the premium rate you will be required to pay. These payments are normally made on a monthly basis and represent the cost of enrollment. Providers with plans that are decked with mountains of benefits will usually charge more from their premiums. Nevertheless, these “high-tier” plans can still save you money in the long run if you take full advantage of their offerings.
The cost of co-pays will naturally be different from provider to provider and are worth evaluating as well. A co-pay is a charge you are expected to pay up-front whenever you receive eyecare services or make eye-related purchases. Many vision insurance plans make co-pays quite affordable (VSP Individual Vision Plans features an exam co-pay of only $15 for most of its plans and a basic materials co-pay of $25).
A frame allowance is also a benefit of most vision insurance plans. This is a set maximum amount of money that can be spent on eyewear without costing you anything beyond the materials co-pay. If you expect to go through glasses quickly, are looking to buy expensive frames, or routinely order contact lenses, plans with higher allowances will likely be more beneficial. Some providers will even offer discounts if you exceed the spending limit so you’re never truly paying full price. VSP Individual Vision Plans include 20% savings on additional glasses and sunglasses (including lens enhancements) from an in-network doctor within 12 months of your last eye exam.
Out-of-network Doctors and Vision Insurance
Sometimes you might find yourself in need of products or services from eye practices outside of your vision insurance network. Not all insurance plans play nicely in these scenarios, but several will still help you out with the bills in some way.
An out-of-network doctor is simply a doctor that isn’t amongst your insurance provider’s network of practices, meaning you aren’t obligated to receive reimbursement for any money you spend there. In-network eye doctors have made prior arrangements to support your provider’s insurance packages.
While an out-of-network eye doctor appointment will usually be a more expensive visit overall, some insurance providers will still reimburse you up to a set amount for an exam or eyewear when you stray out of the network. Vision insurance plans tend to offer limited coverage for out-of-network ventures, but not always. Double-check your plan’s description to see how much coverage you can count on if you choose to see an out-of-network doctor.
Other Benefits of a Strong Provider: Online Retailers
Plenty of online retailers will have glasses and contact lens selections that are more affordable and customizable compared to the inventories you might find at your local optical shop. All you need is a refractive prescription from your eye doctor to get started.
Vision insurance providers that keep you covered when shopping online are a big benefit in today’s tech-enabled world. A provider that allows you to flexibly spend your frame or contact lens allowance on a wide range of online optical retailers is an important consideration in your search for the right vision insurance plan - especially if you’re a creative type who prizes personalization and convenience in your eyewear.
General Health Insurance vs. Vision Insurance Providers
Before you embark on your vision insurance journey, it pays to fully understand the differences between private “full” health insurance providers and vision insurance providers. After all, there’s a reason you’re likely considering a standalone vision plan over the vision benefits your health insurance package already offers.
In most cases, your health insurance provider will bundle dental and vision insurance together in one package (if they even offer them at all). Although receiving all of your benefits through one source might sound convenient, there tend to be big drawbacks to the vision coverage you’ll ultimately end up using. All-in-one packages might only include a yearly eye exam with no discounts on eyewear spending. Or, they might not cover the ongoing cost of contact lenses very well.
The trouble is, bundling so many benefits into one package allows some health insurance providers to muddle exactly what coverage you have, enabling them to offer less extensive vision benefits by spreading their net wide into many fields of insurance.
Bundled health insurance plans are often not tailored to your unique lifestyle either. If you have healthy vision but your bundled vision plan gives you a large frame allowance, you’ll essentially be paying for something you don’t need.
This bundled insurance conundrum is like subscribing to a streaming service that has thousands of movies to choose from…when all you really want is to watch a couple of hard-to-find films. Some might consider the large, untapped selection as a bonus, but others will see it only as a waste. Consider your vision insurance options (and indeed, all of your insurance plans) in the same way to make the best choices between providers.