What is vision insurance?

What is vision insurance?
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Vision insurance is a supplemental insurance that is designed to help cover and finance the costs of continued vision care, such as routine eye exams, glasses and contact lenses. In many cases, insurance companies give you the option of buying it along with dental insurance.

Vision Insurance: Article Contents:

What Is Vision Insurance?

We rely on our eyes for all sorts of daily activities: studying, working, walking down the street, driving a car... Having healthy eyes is essential, as is avoiding or reducing the consequences of their deterioration and aging. Vision insurance is a supplemental insurance that, at a minimum, covers eye exams and glasses.

According to the Affordable Care Act (ACA, also known as "Obamacare"), all Healthcare Marketplace plans include pediatric vision coverage for an annual eye exam and some material benefits (e.g., glasses) for children and minors under 19, but only some plans extend this coverage to adults. If you need a vision coverage plan for adults that includes refractive errors (myopia, hyperopia, astigmatism), diseases such as conjunctivitis, or material coverage in the form of contact lenses, glasses or frames, it’s a good idea to buy a vision insurance plan to reduce your vision care costs.

Most vision insurance plans are wellness or discount plans that provide some specific services and discounts in exchange for an annual premium. Depending on the type of service provided, it might be accompanied by a deductible or small copay. For example: if a general vision exam costs, say, $160 without insurance, you would just have to pay a $15 copay with vision insurance, saving you $145. We recommend that you check with your eye doctor or their clinic staff to get a better understanding of the services that are available with your insurance plan and how much each of these costs.

Why Is It Important to Have Vision Insurance?

The number of people affected by the most common eye conditions is expected to double between 2010 and 2050. In the United States, the number of people with cataracts will surge from 24.4 to 50 million. For glaucoma, that number will rise from 2.7 to 6.3 million. On the bright side, the World Health Organization assures that "more than 80% of all vision impairment globally is considered avoidable or curable," despite the time we spend in front of video screens and other electronic devices.

What Does Vision Insurance Cover?

When purchasing vision insurance, you should carefully read the terms and conditions of your policy. Typically, companies offer minimum coverage, which includes vision check-ups and glasses and/or contact lenses, as well as discounts on surgery for refractive errors (e.g., myopia). Eye exams are important, and should be done once a year to help detect any eye conditions early. What’s more, these check-ups can also help detect other conditions, such as diabetes, high cholesterol, high blood pressure, etc. Vision insurance can lead to major savings for something you know you will have to deal with sooner or later, as eyes naturally deteriorate as we get older.

Vision insurance combined with dental insurance

Most insurance companies tend to offer combined insurance, which merges vision insurance and dental insurance into a single policy. It provides a series of benefits for routine eye exams and glasses and contact lens purchases, as well as discounts on other types of services that are covered under that policy’s conditions. However, independent vision insurance also offers these benefits and also provides the flexibility of choosing, for example, between glasses-only coverage, contact lens-only coverage or coverage for both.

Choosing your eye doctor

When receiving vision care, even if you don’t have an eye doctor, or if your regular eye doctor is not in your plan’s professional network, you’re usually free to choose your specialist, though at a higher out-of-pocket cost. In contrast, if your eye doctor belongs to the available specialist network, you won’t have to change doctors and you’ll save a significant amount of money. It’s a good idea to consult the list of specialists your vision insurance plan offers.

Types of Plans

There are three main types of vision insurance plans:

  • Indemnity health insurance:

    This is a traditional insurance plan that gives policyholders the freedom to choose a specialist.

  • Health maintenance organization (HMO).

    This is a network of healthcare service providers with reduced rates for its customers. However, policyholders must stick to these specialists.

  • Preferred provider organization (PPO). This is a group of providers similar to an HMO, except the policyholders have the option to pay more and be seen by eye doctors who are out of the PPO’s specialist network.

Common Eye Conditions

These are some of the most common eye conditions. You’ve probably heard of some or all of them:

Eye conditions

Name

Description

Affected Eye Part

Myopia

A common refractive error in which close objects are clear, but faraway objects are blurry

Retina (the image of the object we see is formed in front of it)

Hyperopia

The opposite of myopia: faraway objects are clear, but close objects are blurry

Retina (the image of the object we see is formed behind it)

Astigmatism

Like the previous two, another common refractive error. The eye does not focus the light evenly on the retina

The curvature of the cornea is not uniform

Conjunctivitis

Inflammation of the conjunctiva. Allergies, bacteria, or viruses are the most common causes

Conjunctiva (mucous membrane of the inside of the eyelids that extends to the front of the eyeball)

Presbyopia

Also known as "age-related farsightedness." It develops as we age. The eye is incapable of focusing on close objects. This is the most common vision disorder and affects almost the entire population over the age of 40 or 45

Crystalline lens (the lens located behind the pupil and in front of the retina)

Lazy eye

The eye and the brain aren’t coordinated and the brain is favoring the other eye. "Lazy eye" is the common name for amblyopia.

It may be caused by conditions such as crossed eyes, cataracts or anisometropia (when the eyes have different refractive powers). If detected in childhood, it can be corrected

Retinal detachment

The retina separates from its connective tissue

Retina (converts the images we perceive into nerve impulses and sends them to the brain via the optic nerve)

Glaucoma

A group of diseases that can damage the eye’s optic nerve. If not treated in time, it can result in vision loss or blindness. Glaucoma is the second most common cause of blindness worldwide

Poor eye drainage, which can cause damage to the optic nerve, for example due to increased intraocular pressure.

Cataracts

Cataracts are age-related and occur when the lens starts to become opaque, affecting your vision. More than half of Americans over 80 suffer from cataracts.

Loss of transparency of the eye’s lens. Aging is one of the main causes associated with cataracts

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