Everything You Need To Know About Vision Coverage

A good health insurance plan can help cover unexpected medical costs and prescriptions. In addition, ensuring you've got the right level of coverage to help protect your vision can be essential if you or your family are likely to need regular visits to the eye doctor.

At Health Plans of NC, we specialize in assisting residents throughout North Carolina. Our dedicated and experienced health insurance agents can talk you through some of the best vision insurance plans available to get you the coverage you need. 

What is vision insurance?

Specific vision insurance is an added benefit that helps to pay for the cost or help to reduce the costs of eye exams, routine eye care, prescriptions for contact lenses and glasses, and other vision services. Some plans may even offer discounts on corrective eye surgery and LASIK procedures.

What's the difference between medical and vision insurance?

Understanding the difference between medical and vision insurance can be confusing, mainly because you can purchase vision insurance as a supplement to many health insurance plans. 

By considering the type of eye exam you need, and why you're visiting an eye doctor, you can work out if your eye visit falls under medical or vision insurance.

Routine visit: typically relates to a general check-up to test the health of your eyes and can result in diagnosing nearsightedness or astigmatism.

Medical visit: usually means you're visiting for a specific purpose or issue, such as seeking treatment for conjunctivitis.

Understanding your vision coverage

Suppose you've got medical insurance and vision insurance. In that case, it's essential to understand each plan's coverage and know how your insurance provider manages routine eye exams vs. medical eye exams.

For example, if your provider classes your visit as medical, your medical insurance will likely cover your costs if you have eye health problems. If you purchase separate vision insurance, you can expect to be partially or fully covered for routine check-ups, including costs associated with buying glasses and contact lenses.

Vision coverage rules can be complex, so it’s a good idea to check your medical and vision insurance policies carefully to determine what’s included. If you have any questions, our expert team of health insurance brokers NC can help, or you can check directly with your insurance provider, as each provider is likely to have slightly different rules. 

While it can be worth checking with the eye doctor when you visit, you’re responsible for understanding deductible and co-pay limits. Knowing this information can help maximize your benefits to get the most from your insurance plan. 

Vision insurance coverage

Vision plans usually pay some costs associated with basic preventive care, including vision tests, eyeglass lenses and frames, contact lenses, and lens protection, such as scratch-resistant coating for your glasses. In addition, some vision insurance plans offer extra coverage, including discounts on eye surgery and daily disposable lenses. 

Each policy differs depending on the provider, so it's essential to compare plans and find the right one for you and your family. For example, suppose you're looking for coverage for your children. In that case, it's important to note that all medical plans (not vision plans) available on the Insurance Marketplace typically include vision coverage for children. So a separate vision insurance plan may not be necessary, unless you’re looking for coverage for adults which aren’t typically covered. 

Is vision insurance necessary?

Vision insurance can also benefit people with poor vision or a family history of eye disease. Having the right level of coverage can also be beneficial if you have any condition that may increase the risk of eye disease, such as diabetes. 

If you think you'll only need a routine exam every few years, then vision insurance may not be necessary. However, if you need corrective lenses or any preventive care, it's worth considering taking out a policy to help cover costs associated with your eye care. 

Having vision insurance can mean you're more likely to have regular eye exams, which can help detect any hidden medical problems associated with your vision. A good guide for people between 20 and 39 is to visit an eye doctor every five to 10 years. If you're over 40, the recommendation reduces to every two to four years; for over the age of 55, recommended visits drop to between one and three years. Doctors recommend adults over 65 visit an eye doctor every one to two years, which means vision insurance can benefit older people. 

Vision discount plans

Vision discount plans are a different type of insurance plan than typical vision insurance. A vision discount plan only offers discounts on vision care and is typically cheaper than vision insurance. It's important to consider how often you'll need an eye exam or new lenses when deciding on the right plan. For example, if you regularly visit an eye clinic, it may be worthwhile taking out vision insurance to help cover the costs of preventive care or corrective lenses. 

Need more information?

When it comes to finding out what is the best vision and dental insurance for you and your family's needs, it's helpful to get professional advice. Talking to an experienced health insurance agent can help you decide on the right plan for you that suits your future health needs and your budget. We have access to plans on the Health Insurance Marketplace and can provide you with lots of information about Medicare vision coverage. Get in touch with our locally based North Carolina team to find out more.