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Eye Health Insurance - Do You Need It?

Is Vision Insurance Right for You? Updated - July 2007

These days it seems you can get insurance for just about anything, including your eyes. You would insure your teeth, and you would insure your body, so why wouldn't you insure your eyes if you had the opportunity?

In this comprehensive review, we will describe all the benefits there are of eye insurance. You will find out how to get eye insurance, and whether eye insurance is a smart choice for you and your family. Take your time, review the article and consider talking to your optometrist or eye doctor about it. They may also offer discount plans that can substitute for eye insurance in a pinch.

Benefits Of Eye Insurance
Eye insurance provides many benefits, depending on the type of plan you invest in. Like health insurance, you have multiple options when selecting a vision insurance policy.

Most ordinary policies cover things including:

  • Yearly eye exams or eye exams every two years
  • Discounted eyeglasses or contact lenses
  • Discounts for prescriptions including prescription medications for infections or artificial tears if needed

What Eye Insurance Covers
As mentioned above, what vision insurance covers depends largely on the policy you have. Medicare and Medicaid do offer some vision benefits you can take advantage of, and you should if you qualify.

Medicare offers four different programs to eligible participants. You can get Part A, Part B, Part C or Part D coverage. Part A covers hospital care, including eye emergencies that may require a trip to the emergency room.

Part B covers ordinary medical problems, including the cost of an eye exam. If you have eye diseases like glaucoma, Part B should cover this for eligible candidates.

Part C covers much of what Parts A&B do with a few added benefits. For example, in addition to your eye exam, you may receive partial coverage for lenses. Part D offers coverage for prescriptions like artificial tears or antibacterial agents in the event you contract an eye infection.

Medicaid offers partial vision coverage to eligible candidates who live within a certain income bracket. Services may include coverage or partial coverage for eye exams, frames and/or lenses.

Other forms of insurance include those you acquire through an employer. These plans are usually an addendum to an existing healthcare insurance policy. You should be able to review your plan document provided by your employer and discuss the types of benefits you receive and any deductibles you may have to pay to receive eye care benefits. Most plans cover as mentioned, typical needs including eye exams and partial coverage for lenses, prescriptions and medical coverage for emergencies or diseases affecting the eye.

How To Get Eye Insurance
If you do not qualify for Medicaid or Medicare, or do not have an employer-sponsored program you can take advantage of, you can still take advantage of independent vision insurance. There are policies individuals can buy that offer discounts on eye exams and lenses.

Many eye doctors provide information and brochures on different vision protection plans you can enroll in. Make sure you review them carefully. Find out:

  • What vision services, like eye exams, are covered, and how often
  • What services you have to pay for
  • Whether you have to pay a deductible, and if so how much
  • What the rules and regulations are for taking advantage of your vision benefits
Some companies for example, may require you pay in advance for your appointment, and then submit your bill to the insurance company for partial or full reimbursement. Make sure you know exactly how much your vision insurance provider covers. Most plans cover between 60-80% of the costs of eye care, depending on the deductible you select, and whether you see an in-network or out-of-network provider.

Education Is Key To Selecting The Right Plan
If you do not have vision problems, you may not need vision insurance. Check with your medical insurance provider to see if they cover annual exams. If they do, and you do not have any vision problems, you probably will not need to buy separate vision insurance.

If however, you have a history of vision problems, then check out what vision plans are available, and make a selection based on your personal preferences, budget and needs. Keep in mind may eye care clinics offer discounts to people that do not have vision insurance. You can for example, buy a less expensive pair of frames and lenses to compensate for lack of vision insurance.

Many eye care clinics offer special features including high-tech lenses that often are not necessary, especially if you do not have insurance to cover part of the cost of your eyewear. You can also look for clinics offering specials, like a free eye exam when you buy a pair of prescription lenses. You will not need this naturally, if you do not have vision problems.

Most of the time, a vision exam is not too expensive however. Check around, and see if you can get a recommendation from a good friend. Chances are high you can find someone offering an eye exam for less than $50.

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