According to studies, people who have full-service vision insurance plans are more likely to get a comprehensive eye test than those who have combined coverage with their major insurance plan. Furthermore, they also get more eye exams in consecutive years. This only goes to show the importance of these plans if you want to maintain the health of your eyes.
There are many fine prints in these plans however, 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 amount 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 services and discounts
- If you are allowed to use out-of-network providers
- How to process reimbursements, if applicable
- The amounts that can be reimbursed for each kind of service
Once you have the information on how to use your plan, you can now schedule an eye exam with the doctor. Check if Costo is a member of their network because if it is, you can get a Costco eye exam. Their optical shop also has a wide selection of eyewear that you can choose from.
As you are getting an appointment, you will need to provide their office with the name of your insurance company, your ID number, and the benefit you want to avail. There are instances when the doctor’s office will have to get an authorization from the insurance company before the exam can be performed.
Once you arrive in the clinic, you may have to show your insurance ID or you may be asked for any proof of plan coverage. If you will be in need of prescription eyewear, the ophthalmologist or optometrist may fit you with contacts or ask you to pick out eyeglasses from the optical shop.
Depending on the benefits coverage, you may be asked for a co-pay and/or a deductible. It is also possible to receive discounted prices for the exam and other services. This is the beauty of using a provider that’s a part of the insurance provider. If the clinic or the doctor is an out-of-network practitioner, then 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 for 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 in the list of preferred doctors
- You have to travel far to get to the nearest network provider
- The network provider’s schedule is always booked and the next possible appointment is inconvenient for you
- The frames available in the preferred provider’s optical shop are not your style
- The lenses that you need are excluded from the plan’s coverage
- When a cheaper service is available outside the network
- When you need to undergo a PRK refractive or LASIK surgery—this is a very important procedure so you will want to go to the best doctor, even if he or she is not part of the insurance network
The Importance of Vision Insurance
The Vision Council conducted a study in 2013 and it revealed that the second most requested benefit is vision insurance (next to dental benefits). The main reason is that eye health can reveal signs and stages of health risks, like glaucoma, cataracts, hypertension, and diabetes. Unfortunately, more than 20% of Americans do not have coverage for even the simplest eye exams.
Insurance premiums, although very important, are hard on the budget. For this reason, people prefer not to purchase them at all. Studies have shown however, that individuals who lack insurance have a lower chance of using preventive benefits. Preventive benefits (like eye and dental exams) are usually built within insurance policies. The cost is covered 100% after deductibles or co-pay. What this means for people with insurance is that health issues are detected at an early stage, which means lower medical bills at the end of the day.
It will only take minutes to enroll for this benefit and a lot of insurance companies do not deny applicants even if they have pre-existing eye conditions.