How To Choose a Vision Insurance (Benefits) Plan

If you are among the more than 50 percent of U.S. citizens who already wear prescription glasses or contact lenses, you might consider taking advantage of a plan offering vision benefits either through your employer or directly from an insurance or vision benefits company.

Company owners looking for an affordable way to attract and retain good employees also might think about adding vision coverage to employee benefits packages.

Vision insurance comes in the form of either a:

• vision benefits package or a
• vision discount plan.

A vision benefits package provides coverage for services including eye exams in different ways, such as requiring a co-payment from you at the time of service with the balance to be paid by your plan. In a vision discount plan, you pay fully for services but at a lower price that the network provider has agreed to charge.

When you purchase vision insurance, whether it is a benefits package or a discount plan, you buy two products:

Access to a network of eye care providers who have agreed to give service at lower than retail prices, including optometrists and ophthalmologists, eyeglass and contact lens manufacturers, optical laboratories, and (possibly) LASIK and other refractive surgeons.

Specific eye care services, such as eye exams and prescription lenses.

Therefore, when choosing a vision insurance plan, you need to evaluate both the eye care provider network and the services being offered.

[Read more about understanding provider networks and types of vision plans]

To evaluate vision benefits packages and vision discount plans, ask yourself these questions:

1. Which vision plan provides services that best meet my needs?
    
2. Which vision plan saves me the most money? (Individuals and company representatives will, of course, have different criteria when answering this question.)
    
3. Are quality assurance mechanisms and easy-to-follow grievance procedures in place?
    

To analyze different vision plans for coverage as an individual, you first need to estimate your present and future eye care needs.

Begin by reviewing one or two years in your personal records to find out what kinds of eye care services you and your family members have used in the past and how many times these services were used by each family member. This information will give you an idea of what your future needs will be.

Basic services typically include an eye examination with dilation, an eyeglass frame, a pair of eyeglass lenses (single, bifocal, and trifocal, or other certain special designs), contact lenses, and LASIK or PRK refractive surgery.

A list of value-added services that might be covered under vision benefits could include progressive lenses, high-index lenses, polarized lenses, polycarbonate lenses, plastic photosensitive lenses, blended segment lenses, ultraviolet coating, and scratch-resistant coating. [Read more about types of eyeglasses and lens coatings.]

Once you have estimated your future eye care needs, analyze the services offered by a variety of vision plans.

Do this by creating and completing a worksheet like the one we've provided in a Word document here (108 kb). Expand the list of services offered or that you are interested in accordingly.

When you have completed the worksheet, you will be able to decide which vision plan best meets your coverage needs.

To figure out which vision plan will save you the most money, create two worksheets. One is for assessing the costs of a vision benefits package, and the other is for assessing the costs of a vision discount plan. (See sample worksheets in the Word document mentioned above.) Expand the list of services for each vision plan as you see fit.

Note: In the retail price category, you can determine prices either by requesting estimates from each provider you want to consider or by reviewing your eye care receipts for the previous two years.

When you have finished completing the cost assessment worksheets, you will know which vision plan will save you the most money.

The final step in the process is to select the vision insurance plan that best meets your provider, service, and cost requirements.