What is vision insurance, and is it worth it?

Vision insurance helps pay for expenses related to eye care, such as eye exams, glasses and contact lenses. It can help people access proactive care to preserve eye health and even detect overall health issues.

Is vision insurance worth it?

There’s more to vision care than prescribing glasses or contact lenses. Even if someone has 20/20 vision, a routine eye exam can reveal the early stages of eye disease, such as glaucoma or diabetes. Prompt treatment can potentially lead to a better outcome.

Eye exams can also provide a time to discuss issues such as eye strain or fatigue caused by blue light in devices, such as phones and computer screens.

How does vision insurance work?

Vision insurance works much like other types of insurance coverage. A plan helps cover vision care expenses in exchange for a monthly cost. Plans may be offered through an employer group plan or purchased as individual policies.

Many vision insurance companies cover the cost of an annual eye exam performed by an in-network provider. These policies may also offer help paying for glasses and contact lenses up to an annual maximum amount.

Is vision insurance the same as health insurance?

Vision and health insurance cover different aspects of health. Much like a dental plan provides specialized coverage for oral health, a vision plan focuses on providing specialized eye care. Meanwhile, health plans offer broad coverage for the rest of the body.

Most health plans do not cover vision issues unless there is a medical reason to see a health care provider or in an emergency. Medical eye concerns include eye infections, floaters, eyelid styes, chronic dry eyes, glaucoma treatments and loss of vision caused by a medical eye condition. Vision plans will defer to health plans for coverage in these medical situations.

What does vision insurance cover?

Here are some common types of eye care coverage. Plans vary, so check individual plan details.

What does vision insurance not cover?

In addition to medical eye conditions, vision insurance typically does not cover the following:

• Non-prescription glasses (e.g., reading glasses)
• Non-prescription contact lenses (e.g., colored contact lenses)
• Additional eye exams (beyond the number of covered exams)

How can someone get vision insurance?

Vision plans may be accessible through:

• An employer-sponsored vision plan: Some employers offer a vision plan and may pay a portion of the monthly cost to help reduce employee costs.
• A spouse’s or parent’s plan: Spouses or dependents under age 26 may be able to enroll in a spouse’s or parent’s plan through their employer.
• COBRA (Consolidated Omnibus Budget Reconciliation Act): Through this federal law, existing vision coverage may be continued for those who have experienced qualifying events, including termination of employment (for a reason other than “gross misconduct”) or a reduction in work hours.¹
• Private plans: Private insurance companies may offer individual vision plans (not based on employment).
• GuideStone^®: Those eligible for GuideStone vision plans include paid employees working 20 or more hours per week at an eligible church, agency or institution affiliated with or that shares common religious bonds with the Southern Baptist Convention^®.
• If vision coverage is unattainable, some community health centers offer free or low-cost vision care. Universities with an optometry or ophthalmology program may also offer low-cost care. Other vision programs² may also be available.

Vision Plan Terminology Explained

Vision coverage may have fixed co-pays or cover a percentage of expenses. When researching policies, check for details to understand how the plan functions. Here are some common terms:

• Co-pays: This is a flat amount a plan member pays for covered vision care such as frames or contact lenses.
• Deductible: This is the amount a plan member pays out-of-pocket before the plan’s co-insurance kicks in.
• Co-insurance: This is the amount a plan pays for eligible services after the deductible is met. For example, a plan may have 80%/20% co-insurance. This means that after the deductible is met, the plan will pay 80% and the plan member will pay 20% of future costs.
• Annual maximum: This is the most a vision plan will pay for the year. Once the maximum is met, the plan member is responsible for 100% of vision costs for the rest of the year.
• Waiting period: Some vision plans require members to wait a specified period of time before covering services. Keep in mind that preventive services may not be subject to this waiting period.

How to Minimize Vision Care Costs

Take advantage of routine eye exams to detect issues early that, if left undetected or untreated, could require more extensive and costly care. For plans with networks, select in-network eye care providers for the lowest costs. If eligible, pay for qualified vision expenses with pre-tax money from a Health Savings Account (HSA).

Gain a Clearer Vision of Well-being

At GuideStone, we offer vision plans to promote your well-being, along with guidance on preventive care, tips for exercising on a budget, encouragement to rest and much more. For more information, contact us at Insurance@GuideStone.orgor 1-844-INS-GUIDE (1-844-467-4843), Monday through Friday, from 7 a.m. to 6 p.m. CT.

GuideStone welcomes the opportunity to share this general information. However, this article is not intended to be relied upon as legal advice or medical advice, diagnosis or treatment.

¹DOL.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/an-employees-guide-to-health-benefits-under-cobra
²NEI.nih.gov/learn-about-eye-health/healthy-vision/get-free-or-low-cost-eye-care