Things to Know About Vision Insurance

Things to Know About Vision Insurance

According to some studies, if someone has a full-service vision insurance plan, he’ll be far more likely to get a comprehensive eye test than those with a combined coverage with their major insurance plan. Furthermore, they also get more eye exams in consecutive years, which shows the importance of these plans to maintain the health of your eyes.

However, there are many fine prints in these plans, so you should be able to understand them fully. These are the things that you need to know:

  • The services you are entitled to in your plan
  • List of network providers
  • Scheduling a meeting with an eye care provider
  • The quality assurance checks that they make
  • Their process for addressing concerns and complaints
  • Obtaining an ID card, if needed
  • The number of your pay deductibles before they share the expense
  • The amount of co-pay for every service
  • Deductibles you must pay before you can avail of the discounts
  • If you can expect discounts if you pay out of pocket
  • Process for payment of benefits and discounts
  • If you are allowed to use out-of-network providers
  • How to process reimbursements, if applicable
  • The amounts that you can reimburse for each kind of service

Eye Exam

Once you have the information on using your plan, you can schedule an eye exam with the doctor. Check if Costo is a member of their network because if it is, you can get a free or discounted Costco eye exam. Their optical shop also has a wide selection of eyewear.

As you are getting an appointment, you will need to provide their office with:

  • the name of your insurance company
  • your ID number
  • the benefit you want to use

There are instances when the doctor’s office must get authorization from the insurance company before you can perform the exam.

Once you arrive at the clinic, you may have to show your insurance ID or ask for any proof of plan coverage. If you require prescription eyewear, the doctor may fit you with contacts or ask you to pick out eyeglasses from the optical shop.

Depending on the benefits coverage, the doctor may ask for a co-pay or a deductible. It is also possible to receive discounted prices for the exam and other services. You can use this benefit when using a provider part of the insurance supply chain. If the clinic or doctor is an out-of-network practitioner, you will most likely pay the entire amount of the service. Keep the prescription or medical certificate and the receipt because you will need them when you submit reimbursements. Before you go to an out-of-network provider, ensure that the plan will reimburse you the amount of the service.

Reasons Not to Use Your Vision Benefits

There are situations when it is not preferable to use your insurance. These are some of the examples:

  • When you can only get the services of the providers, you’re not comfortable with
  • The ophthalmologist or optometrist you want to go to is not on the list of preferred doctors.
  • You have to travel far to get to the nearest network provider
  • The network provider’s schedule is always busy, and the next possible appointment is inconvenient for you
  • The frames available in the preferred provider’s optical shop are not your style
  • Your plan’s coverage excludes the lenses you need
  • When a cheaper service is available outside the network
  • When you need to undergo a PRK refractive or LASIK surgery—this is an essential procedure, so you will want to go to the best doctor, even if they are not part of the insurance network.

The Importance of Vision Insurance

The Vision Council conducted a study in 2013. Vision insurance (next to dental services) is the second most requested benefit. The main reason is that eye health can show signs and stages of health risks, like glaucoma, cataracts, hypertension, and diabetes. But unfortunately, more than 20% of Americans do not have coverage for even the most straightforward eye exams.

Insurance premiums, although significant, are hard on the budget. For this reason, people prefer not to purchase them at all. However, studies have shown that individuals who lack insurance have a lower chance of using preventive benefits. Therefore, most insurance policies include these preventive benefits (like eye and dental exams), and the cost is covered 100% after deductibles or co-pay. For people with insurance, this means that they can detect any health issues at an early stage. By doing this, you get lower medical bills in the long run.

Enrolling in this benefit will only take minutes, and many insurance companies do not deny applicants even if they have pre-existing eye conditions.