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Vision Insurance: What You Should Know

Heather Larson

Bad news: The Affordable Care Act, also known as Obamacare, doesn’t mandate that health plans purchased through the exchanges must cover vision for adults. However, that shouldn’t stop you from buying it, especially if you’re age 40 or over, which is typically when your eyesight may start to deteriorate. Regular eye exams can also reveal common conditions such as cataracts, retinal degeneration and glaucoma.

vision insuranceWhile the ACA doesn’t address vision insurance for adults, it does cover children age 19 and under, says Theresa Roma, employee benefits administrator for Niagara National Insurance Group in New York.

“Vision insurance is important for people of all ages and should be a part of their larger health care routine, which results in their overall wellness,” says Ken Stellmacher, senior vice president of VSP Individual Plans in Sacramento, Calif.

Eye exams also serve as indicators for other health issues. The same tissue and blood nerves found in the eyes are replicated in other parts of your body, meaning doctors may detect health problems by examining your eyes. Early stages of diabetes, hypertension and more are often visible to ophthalmologists well before the onset of symptoms of those conditions, says Jeff Spahr, president of vision services at WellPoint Inc.

Why do you need vision insurance?

More than 150 million Americans wear corrective eyewear, according to a 2008 report by the National Eye Institute, making coverage and treatment essential. The report also found that Americans spend $15 billion a year on eyewear, which includes glasses and contact lenses.

Those dollars spent could be reduced if more people had vision insurance. According to Vision Service Plan (VSP), a nonprofit organization that provides eye and vision care benefits in the U.S., about 62 million people don’t have any kind of vision coverage.

Vision insurance covers an annual or biannual eye examination, lenses or a discount on lenses, and an allowance toward frames. Some plans even provide a discount on laser eye correction, Roma says.

Where can you buy coverage?

Vision insurance can either be purchased from your employer, if offered, or you can buy an individual policy. When your employer offers vision insurance, usually he pays a portion of the premium and you contribute the rest through a payroll deduction, says Stellmacher.

However, according to Stellmacher, more than 80 percent of Americans don’t have access to vision insurance through their employer, so it’s necessary for them to shop for their own.

If you are shopping for individual vision insurance, you have a choice of providers including Humana, United Healthcare, Aflac, VSP and Aetna.

Unlike the difficulties experienced by people trying to get health care through the ACA, vision insurance is easy to come by.

Spahr says if you prefer, you can work with an agent to find the best vision coverage for you and your family. No matter how you obtain coverage, the cost will be about the same.

For an individual, you can expect your premiums to be $16 or less per month, Stellmacher says, depending on how much coverage you get and what state you live in.

If you add a partner or a family to the policy, your premium will increase. Depending on the state you live in and the type of coverage you choose, a family vision policy may cost $25 a month, Roma says.

Is it difficult to get vision insurance?

A vision insurance application is much simpler to fill out than a health insurance one, Stellmacher says. The application can be filled out in minutes and applicants, if approved, will receive coverage within five business days. More good news: Your application won’t be denied if you have a preexisting condition.

Your child may also be eligible for Children’s Health Insurance Program (CHIP) coverage; check out your state’s income requirements to find out whether your family will qualify for free or low-cost coverage.

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