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Vision Care Plan: Understanding What Is Covered (And What Is Not)
Are you and your family in the process of selecting a vision care plan? Do you know what will and will not be typically covered under these types of plans? One of the oddities of health care insurance, and indeed one of the gripes that many people have with health insurance plans in general, is that these plans rarely, if ever cover routine eye care. Sure, most plans will cover emergency or surgical procedures related to the eye, but for routine eye care, including, but not limited to eye exams and vision correction, you will need a separate visual plan or else you will have to pay for these services out of your own pocket. This might be manageable for single individuals, but for families with several members needing visual care, this can quickly get expensive. In this article we will outline what most vision care plans will normally cover, as well as some items and services that will usually cost extra.
Vision Care Plan: What Is Covered?
The process of enrolling you or your family in a vision care plan is really rather simple. First you will need to complete an enrollment form. This form will ask a variety questions related to your particular visual or eye-care requirements and will outline the specific policies and procedures associated with the plan. After you are accepted (and most people are unless there is a serious, pre-existing condition that excludes them from the program), you will be allowed to choose any optometrist participating in your insurance plan. This is usually not a problem because the financial incentive for doctors to participate in such plans is great. Once you have made an appointment with the doctor of your choice, you can expect that the following items will be covered, at least partially:
• Vision Examination. Individuals that have not had their vision examined in at least the past 12 months must undergo an examination before they can get a visual prescription for glasses or contact lenses. These exams involve a complete analysis of the eyes and related structures to ascertain certain problems or abnormalities.
• Lenses. After the exam, and if there is a problem with your eyes that needs to be corrected, your doctor will write a prescription for lenses.
• Frames. Frames are also covered by your vision care plan, although only up to a certain point. Frames which exceed the predetermined limit can be purchased; however, you will have to pay the difference out of your own pocket.
• Contact lenses. Contact lenses will be covered by most visual care plans, but since they are largely considered a cosmetic item, they will only be covered in situations where eye glasses are not appropriate to correct the problem.
Visual Care Plan: What Is NOT Covered?
While most visual care plans will pay for the basics in terms of eye care—exams, lenses and frames—they will not pay for any items that fall outside of that “basic” category. This includes items such as oversized lenses, coated or blended lenses and multi-focal plastic lenses.
When selecting a vision care plan that is ideal for you and your family, consider the current and potential eye care needs of each member of your clan. Depending on the number of people who either do or will need visual care in your family, there are a variety of plans and options you can choose from that may help save you money in the long run.