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Understanding Vision Insurance: What It Does And Does Not Cover

Understanding Vision Insurance: What It Does And Does Not Cover
One of the most commonly offered employee benefits at many workplaces is vision insurance, which is often coupled with dental insurance. That is unsurprising, given that many dental and vision concerns are not covered by ordinary health insurance.
And since almost two-thirds of US adults will wear contacts or eyeglasses or reading glasses at some point during their lives – and many who don’t will nonetheless need eye surgery at some point, it makes a lot of sense to invest in vision insurance. It makes sense even if you can’t get it through your employer, though employer-based plans offer significant group-rate discounts.

But once you decide that vision insurance is right for you, you still need to understand how it works. Specifically, it pays to carefully investigate what vision insurance does and does not cover.

What DOES Vision Insurance Typically Cover?
Not every vision insurance policy is identical. As with other insurance types, policies vary from insurer to insurer and from individual to individual. However, there are still some general statements we can make about what vision insurance typically covers.

The most basic policies will still reimburse you for at least a portion of expenses stemming from an annual eye examination, vision tests, contact lenses, eyeglasses, and frames. Many policies will also include coverage of scratch-resistant coatings for lenses and other lens-protection methods, along with coverage for disposable contacts, Lasik laser eye surgery, other corrective eye surgeries, and more.

Some of the most common eye problems covered by vision insurance include cataracts, glaucoma, and macular degeneration. But lesser-known eye diseases and vision loss are also covered by most policies.

Besides how comprehensive a plan is, you have to think about how much of eyecare expenses will be paid for by the insurer. Each plan is set up a bit differently, but you may have a small copayment for eye exams, a deductible, a coinsurance percentage, or the responsibility to pay anything beyond a flat-rate coverage amount (where the insurer pays a set dollar amount for each covered procedure.)

What Is Excluded From Most Vision Insurance Policies?
Not everything is covered by vision insurance. That should come as no surprise since all insurance of every type has at least some exclusions. The important thing is to have several types of insurance that complement one another so as to fill in any “gaps.” Vision insurance is an important component of a full-fledged plan.

First of all, vision insurance does not normally cover accidents or medical conditions that injure your eyes. Your regular health insurance would be expected to pay for that instead.

Unlike health insurance, pre existing conditions are not usually covered by vision insurance. You can still get coverage, and at a fair rate, but the preexisting condition itself will not be covered.

Most plans cover glasses OR contacts but not both. You can switch over from the one option to the other when you hit the next coverage period, however. Vision insurance coverage periods are often one year, but sometimes two years, in length.

If you want specialized frames or lenses, you can get those covered for a higher premium. Or, you can just pay extra under standard coverage. But basic policies may cover only basic, standard frames and lenses.

Many things not covered by a basic policy CAN be covered by an upgraded policy. It’s all about balancing out of pocket costs against savings to find your best overall plan.

What Else Do I Need to Know About Vision Insurance?
Finally, you should also realize that there may be a waiting period when you first commence coverage with your vision insurer. What does “waiting period” mean? It means that benefits or at least full benefits do not immediately take effect. You must wait a specified period of time, anywhere from one month to three years, before enjoying full coverage in all coverage areas.

The natural question arises, “Why do I have to wait? Why shouldn’t full coverage begin immediately?” The reason is that insurers don’t want all or most of their policyholders to sign up only after they begin to have some kind of eye trouble – and then ditch the policy once they’ve gotten the discount on the necessary procedures.

If that were to happen, it would bankrupt the insurers since the way insurance works is that all premiums are pooled and used to pay for everyone’s coverage. If everyone is receiving more out of that pool that they are putting into at the same time, then there wouldn’t be enough funds to go around. But all benefit in that they know their risks are covered, they will receive the benefits should an eye problem or eye-related expense fall upon them at any given time.

One Last Thought!
Many people can save money by having a vision insurance policy in place. If you can get one through your employer or qualify for another discount, you are even more likely to save.

Vision insurance, like health insurance, starts to have higher premiums if you start coverage at an older age – when vision problems become much more likely.

Your eyes are a precious commodity, and you don’t want to end up skipping a needful eye surgery because you can’t afford it. Vision insurance helps prevent that from ever happening. It also helps catch eye diseases earlier since an annual eye exam is a part of every vision insurance plan. Catching eye problems earlier rather than later has a huge positive impact on successful treatment.

To learn more about vision insurance, how it works, and how to custom-build your own policy, contact Flagler County (FL) Insurance Agency today! We are located in Central Florida and have a sterling local reputation!