What’s in your vision insurance plan?

Just like health insurance, there are literally thousands of plans for vision insurance to choose from. Whether your vision insurance plan is one you were given as an additional benefit in your employer health benefits package, or vision coverage you seek on your own through an insurance company there are some basics you should understand to make the most of your vision insurance. Here are some frequently asked questions our patients have posed to us over the years.

How do I find out what my vision insurance plan covers?

If you’ve received a vision plan through your employer, your HR department and the insurance company literature (and website) is often a good place to find out what exactly your vision insurance plan does and does not cover. Most vision packages will cover a fixed set of benefits such as a routine eye exam and a certain amount for hardware or materials. Vision insurance like this will also typically require you to go to a network of participating eyecare professionals.

If I have double coverage, does that mean I can get two pairs of glasses?

It depends on the insurance company and the plans. Some plans will indeed give you two pairs of glasses, but others will only cover what the first plan did not. To find out for sure, it would be best to talk to your eye care professional or your insurance company directly.

Will my insurance plan cover both contact lenses and glasses?

Most vision insurance plans will cover either contact lenses or glasses but usually not both but there are always exceptions.

Will my insurance plan cover a full set of glasses?

There are various material or coating options to add to lenses such as anti-glare or transitions. Each plan is unique in whether such extras are covered or offered to the customer at a discounted price. Some plans cover a set dollar amount for glasses and do not specify what extras are ordered.

What is the difference between my vision plan and my medical plan?

A common misunderstanding about vision insurance is that it covers everything to do with the eye and vision. However, vision plans only cover routine eye exams that are used to generate a prescription for eyewear or contact lenses. Unexpected eye injury, or the onset of certain eye diseases and their related treatments is often covered by your traditional health insurance as it is considered a medical matter rather than your vision insurance plan.

Can I save my benefits and get two pairs of eyewear next year?

Depending upon the type of vision insurance plan you’ve enrolled in, your vision insurance benefits may expire annually. This means if you don’t “use it” you ‘lose it” and the benefits do not carry over to the following year. Since either you or your employer are contributing your hard-earned money toward your vision coverage, there’s really no excuse to skip your annual eye exam or lose the opportunity to get a second pair of eyeglasses or sunglasses that’s specifically designed for you.

I was told that my vision insurance plan covers a full pair of glasses. Why do I still have to pay extra?

Most vision plans will cover a basic pair of glasses or a certain monetary amount towards contact lenses. Any over and above this amount may cost the customer more money. Some insurance companies are not specific about their coverage and will only give “estimates”. It may sound confusing at first, but you can plan to use your vision insurance to your maximum benefit by fully understanding what is specifically covered and by discussing options with your eyecare professional to see how best to apply your vision coverage to your eyecare expenses.

Do you accept my Insurance, and will you bill them for me?

Yes, we will gladly bill your insurance company provided we are contracted with them. Here are some of our most common billed insurance companies:

  • Vision Service Plan (VSP)
  • Regence BlueCross of Oregon
  • Providence Health Care
  • ODS
  • Aetna
  • Lifewise
  • Pacific Source
  • Guardian
  • United Healthcare