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How To Get Vision Insurance

Best For Plan Options: Eyemed

The Beginners’ Guide to Vision Insurance

EyeMed

EyeMed is the best vision insurance company for plan options because it offers multiple plans with things like allowances for frames and no waiting periods.

  • Premiums start at $5 a month.

  • No waiting period

  • Baseline plan only gives a discount on frames

  • Limited options for out-of-network care

EyeMed was founded in Cincinnati in 1988 and has more than 62 million members. Its plans work with major providers such as Pearle Vision, LensCrafters, and Target Optical.

EyeMed maintains three tiers of insurancethe more you pay in premiums, the larger the discount you receive on frames and lenses. Each plan covers the eye exam and provides great discounts on glasses and contacts, plus there is no waiting period.

The most basic plan, EyeMed Healthy, starting at $5 per month, only provides a discount on glasses and contacts in the form of a coupon. The higher-priced plans, EyeMed Bold and EyeMed Bright, with costs from $17.50 to $30 a month, respectively, offer better benefits. These plans give you an allowance for frames and lenses rather than a coupon. With a copay, you also cover the cost of lens improvements such as UV protection.

When you visit one of EyeMed’s more than 100,000 in-network providers, you can receive a 15% off coupon for LASIK, 20% off of the remaining balance of frames over $150, and 40% off additional pairs of glasses.

Buying Individual Vision Insurance

When you enroll in vision insurance on your own, this type of coverage is referred to as individual vision insurance.

There are a few reasons why employer-sponsored insurance might not be an option:

  • Youre unemployed.

  • Youre self-employed.

  • Youre employed but dont qualify for health benefits. Part-time and contract workers can be affected by this.

  • You work for a small business with less than 50 full-time employees that doesnt legally have to offer health benefits under the Affordable Care Act.

  • Your employer only offers health coverage.

Individual vision insurance also can supplement a job-based policy in which you are enrolled. This added coverage come in handy if you have particularly expensive or wide-ranging optical needs.

A big difference between individual and employer-based vision coverage is their sign-up windows.

Individual vision insurance coverage, when purchased through EyeMed, VSP or another provider, can be purchased at any time during the year. Signing up through an employers plan is much more restrictive you can only sign up at open enrollment and during specific scenarios. Well cover these a little later.

Which Is Better Dental Insurance Or A Dental Discount Plan

A dental discount plan doesn’t provide coverage for dental costs it just makes certain discounts available if you use one of their dentists. By comparison, a quality Dental PPO plan will typically provide the same or better discounts when using in-network providers, but you may also get checkups and cleanings covered at 100%. A full-coverage DPPO will also help cover portions of major procedures such as crowns and bridges and may even cover orthodontic care.

2 “Systemic manifestations of oral diseases,” www.ncbi.nlm.nih.gov/pmc/articles/PMC3329699/

3 “Stay in Good Company” Guardian Dental Health eBook

4 Common Glasses Statistics, , Last accessed Nov, 2021

Brought to you by The Guardian Life Insurance Company of America , New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment, or medical advice. Although the information has been gathered from sources believed reliable, please note that individual situations can vary, therefore the information should be relied upon when coordinated with individual professional advice.

Vision Insurance is provided by VSP and billing and premium collection services for such vision insurance are conducted by DTC GLIC, LLC . DTC GLIC, LLC is a wholly owned subsidiary of The Guardian Life Insurance Company of America .

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Who Can I Contact With Questions Or For Help In Locating A Participating Provider

For Davis Vision by MetLife or Superior Vision by MetLife call 833-EYE-LIFE . Available Monday through Friday 8AM 9PM ET and Saturday 9AM 4PM ET. IVR available 24/7.

For the MetLife Vision PPO plan you can call 24/7 at 1-855-MET-EYE1 . Available Monday through Saturday 9AM – 8PM ET. IVR available 24/7.

When It Comes To Your Vision We’ve Got You Covered

Use Your Vision Insurance to Save on Glasses &  Contacts at Eyeconic

With Unum Vision Insurance, you have the flexibility to see any vision care provider and purchase materials at any location, including thousands of independent optometrists. Plus, you can visit top retail providers such as Walmart®, Sam’s Club®, Costco Optical®, Pearl Vision, Sears Optical®, Target Optical, and JCPenney Optical®.

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What Does Vision Insurance Cover

Vision insurance provides coverage for:

  • Eyewear: Vision insurance covers eyewear, such as class, contacts, and occasionally prescription sunglasses.
  • Eye exams: Routine eye exams happen once a year to assess the health, sharpness, and range of your vision.
  • Lens coating and enhancements: Depending on which vision plan you choose, you may be covered for lens coating. Lens coating decreases scratches, fogging, and exposure to ultraviolet rays.
  • Surgery: Surgeries due to eye infection or injury are deemed medically necessary and may be covered by your health insurance. However, your health insurance may not cover a procedure labeled as corrective surgery, such as LASIK. In this situation, vision insurance may cover corrective or cosmetic surgery that pertains to the eye.

Buying Vision Insurance Through An Employer

Your employer may offer some level of vision coverage. This is also known as employer-sponsored or group vision insurance. Vision insurance often is offered alongside health and dental insurance, and you can usually select which types of coverage you want.

Employer-based vision insurance will always be the cheaper option because your company pays for part of your coverage. Your costs for vision insurance coverage are usually only a few dollars deducted every pay period. Your cost per pay period will be higher for vision coverage for your family.

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Do I Need To File A Claim

If you visit an out-of-network provider, you are responsible for paying the provider in full for the services and eyewear received at the time of your appointment, including taxes. Then you must submit a completed MetLife Vision claim form and itemized receipt to the appropriate address:

For Davis Vision by MetLife OR Superior Vision by MetLife:

MetLife Vision Claims

Birmingham, AL 35238-5018

Our Standard Vision Plan Services Typically Include:

Medicare Basics: How to get dental, vision, and hearing coverage
  • Eye exams Get your comprehensive eye exam for a low exam co-pay at thousands of locations nationwide.
  • Eyeglass lenses Single vision, bifocal and trifocal lenses are covered in full by a materials co-pay. Plus, get generous allowances for lenticular and progressive lenses.
  • Eyeglass frames You can choose any frame, with no brand restrictions. Frame allowances are applied toward the purchase of any frame in a provider’s collection.
  • Contact lenses You can elect to get contact lenses in lieu of glasses, with no brand restrictions. The contact lens allowance may also be applied toward any professional fitting fee. Plus, members can order contact lenses online.
  • LASIK surgery While not an insured benefit, we provide discounts on this valuable procedure with participating providers.

Talk with your HR manager about enrolling in Unum Vision Insurance through your benefits package.

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How To Choose An Individual Vision Insurance Plan

With vision insurance quote in hand, weigh your options. Take into account your specific vision needs, along with each plans limitations and maximums. As best you can, try to factor in your potential savings at years end.

Also take note of each companys in-network providers. Large insurance companies like EyeMed, Humana or VSP tend to have more optometrists in their networks, but other companies networks can vary based on a few factors in your area.

Out-of-network coverage may still be available by way of a post-visit reimbursement check from your insurer. The amount of coverage varies plan to plan.

A quick call to your top two or three optical offices can be reassuring, knowing youll have vision coverage one way or another.

Once youve made your vision insurance choice, complete the sign-up process. This is usually completed either online or over the phone. Certain paperwork may also need to be filled out, depending on company policy.

And just like that, your future vision care has become a little more approachable and affordable.

NEED AN EYE EXAM OR UPDATED GLASSES PRESCRIPTION? Find an eye doctor near you whos covered by your vision insurance and book an appointment.

Page published on Friday, April 24, 2020

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How Dental Plans Work And Help Save You Money

Most dental care is preventive: checkups, cleanings, and simple procedures like X-rays and fillings that catch little problems before they become bigger problems. So dental coverage focuses on preventive and basic procedures and one way to help lower the cost of coverage is by getting a plan that only offers those benefits. But if you or someone in your family needs more comprehensive services, “full coverage” dental insurance could be a better value. Full coverage plans typically cover more types of preventive and basic restorative procedures . These plans can also cover major restorative care, such as bridges, crowns, dentures, and the like. Have kids with crooked teeth? Plans with orthodontic coverage options are also available — and they can help save you money by covering portion of the costs for braces and other types of teeth aligners.

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What Does Dental Insurance Cost

In 2022, the average monthly premium for an individual with dental insurance could range between $21 to $60 and $58 to $180 for a family plan. Copays and deductibles may vary from plan to plan. You can compare up to four plans of your choice.

Below is a table of 2022 costs with and without dental insurance for dental exams, fillings, root canals, and denture installations.

Procedure
$750 and more

Best For Contact Lens Users: Humana

Buy Vision Insurance

Humana

Humana is ideal for users who wear contact lenses because it has multiple plans with contact lens allowances and no annual deductibles.

  • No annual deductibles with Vision PPO

  • Only $15 copay on annual vision exam for glasses

  • No cancellations for 12 months

Humana was founded in 1961 in Louisville, Kentucky, and is the largest owner and operator of hospitals in the country. Humana even has a foundation that provides disaster relief to areas as well as support for health organizations based in Louisville.

Customers choose between three vision plan options with Humana: HumanaOne Vision Focus Plan, Humana Vision PPO and a materials only. Coverage costs and options vary from state to state, with most plans starting between $13 and $16 per month. There is a $35 initiation fee charged your first month when you sign up, but the fee is waived if you bundle with dental insurance.

Humana plans include an annual vision exam with a copay of $10 to $15. The HumanaOne Vision Focus Plan gives you $115 to spend on contacts. The Humana Vision PPO gives you $150 for contacts and access to an annual $40 contact lens fitting appointment. Both plans state that you’ll never pay more than $40 for an annual eye exam, and if you choose the Vision PPO, you wont even have an annual deductible.

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What Does Vision Insurance Typically Exclude

Many companies will not fully cover what they consider elective surgery, such as LASIK. Some insurance plans offer coupons to offset the costs. Other medically necessary eye surgeries and treatments for conditions like glaucoma and cataracts will be covered only by your health insurance.

Often, vision insurance covers only specific brands or price ranges when it comes to glasses or contacts. It’s important to understand what is covered so you aren’t disappointed and forced to change styles or brands. Other exclusions vary, depending on the cost and extensiveness of the plan. For example, some cheaper plans may cover only glasses and not contacts.

Common Vision Insurance Plan Limitations

Each vision plan has a network of providers that accept their coverage, so going to an out-of-network provider may not accept the vision insurance at all. Some vision plans have some coverage for out-of-network providers, but not all of them. That coverage may also be limited.

Other limitations of vision insurance are outlined in what they agree to cover based on your specific plan. Vision insurance companies can exclude certain brands of frames or only cover frames up to a certain price point. Also, certain lens specifications may be limited as well. For example, they may only cover a basic progressive lens, not the top-tier choice.

The same goes for contact lenses as well. Some contact lens brands may not be covered by certain vision insurance plans. Also, most plans do not cover both glasses and contact lenses in the same year.

Eye surgeries are often not covered by vision insurance. Some plans offer coupons or discounts for refractive surgery like LASIK, but not all of them. Additionally, surgeries that are considered medical or cosmetic are not covered by vision insurance either.

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How To Lower Out

The out-of-pocket cost you owe for a given treatment or service may vary widely depending on the insurer and specific plan you choose. Generally speaking, they will be lower in a DHMO plan than a DPPO plan, but look at the Plan Summary for a list of costs and complete details. Here are the different kinds of out-of-pocket expenses you can expect to see, with tips on how to help lower them:

  • Deductibles In a DPPO plan, there’s usually a deductible of about $50 for an individual or $150 for a family it’s the amount you have to pay before the plan starts to cover treatments other than checkups. To avoid that cost, choose a DHMO plan because they typically don’t have deductibles.
  • Coinsurance This is the percentage of costs you owe for a visit or treatment once you’ve met your DPPO plan deductible. In a 80/60/40 plan, the insurance company pays 80% for preventive care, 60% for a basic procedure and 40% of the cost for a major procedure, and you are responsible for the rest. If you choose a 100/70/50 plan, your coinsurance will be that much lower. DHMO plans don’t have coinsurance, but you will typically have a copay amount to pay for each service received.
  • Annual maximums DPPO plans usually cap the total amount they will cover for services in a given year, and you are responsible for anything over this maximum amount. If you think you’ll need a lot of dental care, look for a plan with a higher annual maximum, or choose a DHMO because they typically don’t have maximums.

Questions About The Plan

What Is Vision Insurance?

If you have questions about the vision care plan or would like to find a network provider, you may visit myuhcvision.com or call 1-800-638-3120.

While Duke’s medical plans provide coverage for annual eye exams, Duke also offers a nationwide vision care plan to manage the cost of eyeglasses and contact lenses, as well as eye examinations. The vision plan, administered by UnitedHealthcare Vision, allows you to pay for vision benefits on a pre-tax basis. You do not need to be enrolled in any of Duke’s medical plans to participate in the vision plan.

For further details about the vision plan, please refer to:

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How Much Vision Insurance Coverage Do You Need

The amount of vision insurance coverage you need varies greatly. When trying to figure it out, assess your vision needs. If you need cataract surgery or want laser surgery you may need more coverage than someone who wants only a yearly eye exam. Think about things like if you need glasses, wear contacts, and if your prescriptions frequently change. Speak to your doctor about your needs and then discuss them with the insurance provider so everyone is on the same page.

What Vision Insurance Typically Covers

Vision insurance typically includes coverage for

  • Contact lens fitting

Providers may offer higher-tier plans that also include appointments for lens protection and LASIK surgery. Plans may cover certain brands and often have price limits or maximum amounts set for frames and contacts .

Medically necessary eye surgeries and treatments for conditions like glaucoma and cataracts will usually be covered only by your health insurance.

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When Can I Enroll For Vision Insurance

Unlike individual vision coverage, signing up for employer-based insurance is usually limited to certain time periods:

  • Open enrollment period: The most common method of signing up for insurance. The sign-up window varies by state, but usually goes each year from November 1 to a date in mid-December.

  • Qualifying life event : In the wake of a life event, youll be able to sign up or change insurance outside the open enrollment period. Examples of a qualified life event include having a baby, getting married or divorced, losing a family member, losing a job and even certain moving scenarios.

  • Starting a new job: Being a new employee usually means you can sign up for your employers insurance outside the traditional times, but you could be subject to a waiting period.

See The Value Of Vision Coverage

Comparing VSP vision insurance from Covered California

For as little as $6.90 per month, you can get vision coverage with the largest vision network in California. Youll enjoy access to private-practice optometrists and ophthalmologists as well as convenient locations like LensCrafters, Target, Walmart, and Costco. You can order contact lenses online and enjoy valuable LASIK discounts through QualSight LASIK and NVISION Laser Eye Centers.

  • Specialty DuoSM dental + vision package*: Offers the convenience of vision and dental coverage in a single package
  • Ultimate Vision 15/25/150*: A comprehensive vision plan that features a $150 frame allowance and many lens options
  • Ultimate Vision 15/25/120*: If you are looking to save a little money without sacrificing dependable benefits, this plan may be right for you

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