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Do I Need Vision Insurance?

One question I get asked frequently  is, “Do I need vision insurance?  Maybe your job offers vision coverage, or you are thinking about adding a rider to your current health insurance plan. Are you having eye problems and think you should have insurance before scheduling an appointment? Maybe you should just go to Cheapskate Eye Care, Hair Salon, and Donut Shop. Don’t they sell glasses? Do I really need vision insurance?

Vision Plans Only Cover the Basics

The honest answer is no. Vision insurance only covers routine testing of your vision to check if you need glasses or not. It usually has some sort of benefit for glasses or contacts.

Vision insurance doesn’t cover medical problems. If you have cataracts, glaucoma, cancer of the eyeball, or have a dagger sticking out of your eye, your vision plan will not help at all. However, if you know you need vision correction and are good about getting regular eye exams, vision insurance could save you some money.

What Does Vision Insurance Cover?

There are way too many types of vision plans to mention them all, but they tend to have several areas in common. Generally, vision plans cover these things.

  • A routine eye exam every 12 to 24 months.
  • Coverage for a basic pair of glasses or an allowance for contacts every 12 to 24 months.
  • Polycarbonate lenses for children under 18. These are the more impact resistant type.
  • Discounts on non-covered products like anti-glare coatings or no line bifocals. Some really good plans might cover options like this, but most charge a separate fee.
  • Many vision plans offer a percentage discount on LASIK surgery with specified surgeons.

But I Never Go to the Doctor

Vision plans are not like health insurance plans. They offer their benefit every cycle. If you don’t use it, you are throwing away money. It kills me to have patients who have vision insurance but only get an exam every five years.

Does Vision Insurance Make Sense for Me?

Just like everything else that takes your hard earned money, you should look at the numbers. For example, most vision plans cost around $10-$20 per month. If yours is $15 per month, you”d be paying $180 per year to have a vision plan. Let’s look at some examples to see if this makes good financial sense.

Example #1: I have perfect vision but have a family history of glaucoma. I want to make sure I’m not developing glaucoma.

This patient would be better off to drop the insurance and pay for an annual exam. In my office, you could get a full exam and do additional retinal screening photos for less than the price of the policy. If you do develop glaucoma, your health insurance would take over from there.

Example #2: My glasses are really nice and expensive so, I try to make them last a long time.  I only get an exam and glasses about every five years.

This patient has a really high prescription and gets all the bells and whistles. I realize prices vary, but let’s use these for this example.

Without Insurance

  • Exam:$145
  • Frame: $150
  • Premium No Line Bifocals: $225
  • Anti-Glare Coating: $100
  • Extra Thin and Light: $100

Total cost of glasses and exam without insurance: $720

With Insurance (Based on the most common plan I see)

  • Exam:$20 copay
  • Frame:$25 copay
  • Premium No Line bifocals:$93
  • Anti-Glare Coating:$72
  • Extra Thin and Light: $40

Total cost of glasses and exam with insurance: $250

It may seem at first like this patient is saving a ton of money, but remember that he only gets and exam and glasses every five years. He is paying $180 a year to keep the plan, so he has really paid $1150 to change his prescription every 5 years. He would be better to save the money and pay out of pocket. If he gets and exam and glasses every year, he would be paying $430 a year with insurance. Every two years would be $610. At year three, it would make more financial sense to just pay out of pocket instead of carrying a vision plan. 

Example #3: I only wear contacts and wouldn’t be caught dead in my glasses.

Without Insurance

    • Exam: $145
    • Contact Lens Fitting Fee: $60
    • Year Supply of Contacts:$200

Total cost without insurance: $405

With Insurance

  • Exam:$20 copay
  • Contact Lens Fitting Fee: $60-15% discount offered by most vision plans=$50.40
  • Year Supply of Contacts: $200-$120 contact lens allowance offered by most vision plans=$80

Total with insurance:$150.40 +$180 per year for vision insurance premiums=$330.40, a savings of about $75 per year.

4 Questions to Answer Before Getting Vision Insurance

I could list a hundred more examples, but to determine if you need vision insurance, there are really four important questions you need to answer.

-How much do I spend annually on vision care and products?

-How much would my premiums cost?

-What does the plan actually cover?

-Is there a provider I like who accepts this vision plan?

If your plan is confusing, ask a provider to give you a cost breakdown. Calling the insurance company often leads to more confusion.

If you do sign up, make sure you use the plan. Paying for years of premiums and never going to the doctor is a great way to waste money. If you will use it and need help with your vision, insurance might be a really smart investment.

What are your experiences with vision plans? If you have one, do you use it? If you don’t live in the US, what is vision care like for you?

About Kim Parr

Kim Parr is a private practice optometrist, freelance writer, and personal financial blogger. You can follow her journey to 20/20 financial vision at Eyes on the Dollar.

47 comments

  1. Very interesting! I guess I always assumed that anything above and beyond an eye inspection and glasses would be covered by my health care plan through work. Perhaps as I get older and the eye check-ups result in less good news, I may need to consider this rider more carefully.

    • Your regular health insurance should cover any type of eye problem that is not related to vision. It might apply to deductibles and places like Pearl Vision do not bill heath insurance, but you shouldn’t be going there for a medical eye problem anyway.

  2. I’ve worn glasses my entire life and decided with my first job that vision insurance isn’t worth the price for me. I visit the eye doctor every other year and might need a new prescription every 4-5 years. I’ve careful with my frames in that a pair usually lasts me 10 years. Since insurance only covers the exam, I skip the insurance and just save money on my own for the new lenses/frames when I need them.

    • That is usually the smartest thing to do in my opinion. Unless you’re hitting 40 or starting to get cataracts, most adults don’t change every year.

  3. Are eye exams routine even if you’ve never had vision problems? I’ve never had vision problems but I think I might need reading glasses. I usually just buy a cheap pair of glasses and wear them while on the computer or reading. I don’t have a lick of insurance though.

    • Obviously, I don’t know what your eyes are like without examining you, but generally people your age should not be able to see well with the readers from the drug store. You are probably farsighted. The cheap ones magnify which probably prevents eye strain. They aren’t going to hurt anything, but when you get rich from self employment, I would go get an eye exam and see what your prescription actually is.

  4. I only have had vision insurance once from an employer and it really did not save a whole lot of money. I get an exam every year and wear contacts, but we get a discount by paying for the exam up front and get pretty good priced contacts so we don’t have it now. If I were to get Lasik, I might consider it. I am just hoping our kids get my wife’s eye sight as it’s perfect. I couldn’t see a mack truck coming at me without my contacts.

    • Which makes it that more exciting that you didn’t shoot one of those eyes out with fireworks! It sounds like you need all the help you can get.

  5. We are lucky to get our vision insurance super cheap: about $15 a month for the family, because Rick works for a company with great benefits. Being that three of the six of us wear glasses, and that we take the kids in for eye exams yearly, vision insurance works out well for us. Sounds like that’s a rarity, though.

    • If you have a big family, it is usually a huge benefit. We have lots of big families here that make bank with their vision benefits. I can think of a family that has 6 kids that all wear glasses. Paying about $50 per kid a year plus the premiums is a great deal because they all seem to change every exam.

  6. Interesting article, and timely for me – I have been wondering whether or not I should get vision insurance because it’s not offered as a part of my health insurance package from my employer (we get medical, dental, and life, but no vision), and I am blind as a bat. But, it’s just the two of us in our household and I’m the only one in need of contacts or glasses, so it seems like I’d be better off sticking with what we’ve got now.. especially as my current eye doctor offers me a discount on the exam because I do have medical insurance. Thanks for the breakdown of different scenarios; very helpful!

    • I think most people just go ahead and sign up if it’s available and they need glasses or contacts. Same with dental. People need to see how much it costs with and without and decide then.

  7. We’ve never had vision insurance and we will probably never have it. Fortunately, all of us seem to have really good eyesight…at least for the time being!

  8. Our vision insurance is super cheap through our employers, just $2 or so per month for each of us. Considering we both wear glasses and mr pop has a family history of glaucoma, it’s well worth it for us.

  9. Truth be told, I don’t have vision insurance…then again, I’ve got great vision, so I don’t see the need for the expense.

  10. I used to have one with my last full time job but hardly ever used it. I think I have it under my current health insurance and went once when I got an ocular migraine. But my vision was good so I don’t think it’s something I’ll look into getting as extra coverage as a freelancer.

    • I wouldn’t. There is so much competition for eye care in SoCal that you could probably find a good deal if you needed something.

  11. I bought my glasses at $200 and haven’t really needed anything related to vision since then. I can’t say I really need vision insurance but its a good choice for some people.

  12. I do like to have my regular checkup each year and not pay a dime thanks to my vision insurance, but another “supplemental” insurance that I wish covered more was dental. It basically covers nothing for braces or wisdom teeth extraction. My friend was shocked when I told him that wisdom teeth were not covered.

    • Dental does suck. We looked into it when I got braces a few years back. It covered almost nothing. Jim’s dental is $35 per month. Unless I need a crown or root canal, I’ll never spend that much at the dentist in a year. My sister is also a dentist, so if I needed major work, I’d take a trip back to visit.

  13. I just realized that I have a vision plan that is added on with my employer. I totally forgot I got it years ago. I have never used it, but am paying $5 per month. Oops!

    • That’s the problem. It seems so cheap that people don’t realize how much it adds up. $5/month isn’t going to break you, but add that up over 10 years and I can think of other things I’d rather spend it on.

  14. Wow I’m so lucky to have great insurance which covers visits to opthalmologists and optometrists. I didn’t even know that many health insurances didn’t cover that. I guess I’m spoiled. Good thing for me because the doctor said that I’m a “Glaucoma suspect” so I should do the visual field test every year…which reminds me, I need to go. Also, I only have vision in one eye (birth defect) so they are extra careful in making sure my eye is healthy.

    • Health insurance should cover you if you are a glaucoma suspect because that’s a medical code. It might apply to your deductible though. Yes, go get your good eye checked!

  15. I’ve always wanted to ask specifically what the “contact lens fitting fee” actually is, but never had the nerve to ask my eye doctor. Can you tell me why it costs so much?

    It always seems like such a scam to me because this laborious (sarcasm) fitting that costs $60+ cash out of pocket is really just someone tossing me two contact lenses and telling me to put them in my eyes.

    It frustrates me so much that I don’t feel badly at all for using VisionDirect.com for my contacts and thus depriving the doctor of another profit center.

    • Brad, That’s a great question, and I’m glad you asked. It may seem like the doctor is not doing anything extra to fit contacts for you, but that’s actually a good thing. If everything looks good, it takes about 30 seconds to analyze your exam results and look at the contacts on your eye to see if everything is good. However, there are lots of people who wear contacts that don’t work out on the first try. In our office we have a tiered structure. If you are and established patient and don’t need to change, the fee is on only $25. If you need a special order lens and have to do several follow ups, the fee goes up.

      Because a contact lens sits right on your eye, there is the potential for oxygen deprivation, ulcers, etc. You can wear an old pair of glasses for decades and you might not see well, but it won’t affect your eye health. I would love to say it’s all about doctor’s caring for patients, and it is to a certain degree, but lots of it is CYA. If I give you contacts and don’t evaluate and document that they fit and I told you how to wear them, you could wear a monthly lens for a year, get horrible scarring, need a transplant, and go blind. You could sue me for negligence. Think of it like when you go for a dental cleaning. They hygienist scrapes your teeth for an hour, and it costs $100. Then the dentist spends about 5 seconds doing a check and that adds another $35. If all is good it’s quick. If I have mouth cancer, not so quick. I will choose quick any day.

      I do know that in some of the commercial establishments, they write you a prescription and send you out the door without doing much in the way of looking at the contacts on your eye. I don’t agree with this, but that happens. Hope that helped.

      • What a great answer — thank you so much! I feel dramatically better about paying that money now; I never have a problem paying for expertise and clearly doctors have skills that the rest of us do not possess and they deserve to be compensated as such. It just isn’t being communicated properly to the patients with this lens fitting fee.

        It probably couldn’t hurt to give a variation of the above to all of your patients, as I assume some of them are as frustrated as I was…

        • We used to have a form, but no one paid any attention. My staff is pretty good at explaining, but I’m sure there are lots of people who don’t understand. Thanks for reminding me to be more transparent.

  16. In my opinion, vision insurance falls into the category of insurance that people don’t need. “If you can afford to replace it, you don’t need insurance”:

    http://moneystepper.com/waystosavemoney/unnecessary-cost-of-insurance/

    However, as your examples show, you can somewhat plan your future expenses.

    So, if through doing your own example, you can work out that you have a positive EV when taking out vision insurance, then it would seem sensible to take it out.

  17. I have never had vision insurance. I just don’t think it’s necessary. Vision is not really something that changes too often like regular health. If I had vision insurance, I doubt I’d ever use it.

  18. I don’t carry vision insurance even though I wear contacts and my wife wears reading glasses. We pay for all our vision needs (which are minimal) through our HSA plan which we contribute to monthly. Perhaps if the kids grow into some eye issues we would consider it.

  19. I don’t know if I need it, but I am very glad I have it. The best part is it cover my wife and I for no cost (no premiums). In addition, I use my FSA to pay for the expenses of all my medical expenses.

  20. I was diagnosed with diabetic retinopathy in May. This was my first year with a different vision insurance and I found out that the doctor I’ve been seeing for years doesn’t accept VSP. I have cancelled the insurance. Luckily my medical insurance covers the current treatments.

    I’m honestly surprised that getting shots in the eyes does not hurt. Previously, I’ve only had one shot in the eye each visit, but today I will have Lucentis in both eyes. My left eye is 20/400 and the right is 20/50. Any change to the good eye freaks me out.

    • Best of luck. I can’t imagine how scary that must be, but I have heard much the same as you are saying. It really is much worse to think about then go through with.

  21. I didn’t have vision insurance until I started my current job about 4 years ago. Now that I wear glasses (and contacts) the vision insurance is well worth the minimal cost. It’s only a few dollars per paycheck and I go to the eye doctor yearly for an exam and contact fitting.

  22. As I’ve mentioned before, I used to work for ophthamologists, so we saw patients for both vision exams and glaucoma surgery (in NV, where I was, the laws on what services optometrists could provide were VERY strict). Our biggest frustration was with people not knowing whether or not they had vision insurance, or, if they had a medical condition, not understanding that while their medical insurance would cover their exam, it would not cover new glasses or contacts.
    My current employer provides vision coverage at no extra cost, so we have it. I would not pay extra for it, as I don’t wear glasses and glasses from CostCo (without insurance)cost roughly the same amount as glasses from an optical shop after insurance pays.

    • That is a big problem when people think their plan covers thing that it doesn’t VSP is the worst. They don’t even give a card, so people have no clue what they have or what it covers. The general response is something like, “I know I have insurance through my work.” We are such a small town that we tend to know which employers have what insurance. Otherwise, you’d have to just make people pay if they don’t know what they have and have no ID.

  23. Very interesting post. I guess it’s not for all. But for those who see the need for it or at least are considering, if the pros outweigh the cons then why not? There’s no harm and considering and taking time to learn more about something.

    • Vision insurance works great for many, but is a big waste for others. I wish everyone would do their homework before jumping in or declining.

  24. Thanks for sharing this advice on whether or not to choose a vision insurance plan. It really does depend on the person when it comes to eye insurance. I would make sure to talk with a doctor about eye insurance and get their honest opinion. You also need to make sure that you take your kids to the optometrist frequently, especially if they are younger!

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