Is Buying Private Vision Insurance Worth the Cost?

Woman in glasses

Does your health insurance include vision insurance as part of the coverage? Many plans do, but if yours doesn't, you can purchase private vision insurance yourself. Whether it's worth buying vision insurance depends on how often you visit the eye doctor, whether you wear corrective lenses and many other factors. Keep reading to learn how vision insurance works and how to decide if you need it.

How Private Vision Insurance Works

Health insurance typically covers medically necessary vision care. For example, if you injure your eye or have symptoms of eye disease, your insurance generally pays to see an ophthalmologist. Vision insurance, on the other hand, focuses on correcting vision. It usually covers eye exams and corrective lenses and may also pay some costs of elective procedures, such as LASIK, to correct eyesight.

You purchase private vision insurance by paying a premium to the insurance company. Vision insurance coverage can vary widely depending on the plan. Some plans cover the full cost of vision exams, while others require a copay. Some plans pay an allowance (a specific dollar amount) toward corrective lenses at certain intervals (typically every 12 or 24 months); others pay a percentage of the cost or give you a discount. You may be required to see a doctor within the plan's network to get full benefits.

Upgrades such as designer frames, anti-reflective or anti-scratch coating, progressive lenses or edge polishing can increase the cost of eyeglasses significantly. If your vision insurance plan doesn't cover these features, you'll have to pay for them out of pocket.

Vision insurance premiums vary depending on your provider, location and plan. Basic plans are generally quite affordable, but prices rise as you add coverage. For instance, VSP, the nation's largest private vision insurance provider, offers a Standard plan starting at $204 annually for individuals or $529.92 for families, and an Enhanced plan starting at $423.84 annually for individuals and $1,101 for families.

As with health insurance, plans that cover more of your costs generally have higher premiums. For instance, both VSP plans offer exams for a $15 copay, basic eyeglass lenses for a $25 copay and a frame or contact lens allowance of $150. The amount you pay out of pocket for enhancements to your eyeglasses is capped. Under the Standard plan, you pay a maximum of $33 for scratch-resistant lenses and $175 for progressive lenses. With the Enhanced plan, you pay nothing for scratch-resistant lenses and a maximum of $55 for progressive lenses.

Where to Buy Private Vision Insurance

Many health insurance companies sell private vision insurance; so do stand-alone vision insurance providers, such as VSP or EyeMed. Search online for "individual vision insurance" to find carriers near you or ask an insurance agent to help you find the right vision insurance plan. You can also get information about vision insurance carriers from your state's Department of Insurance.

Although you can't buy vision insurance through a retail store, many retailers that sell corrective lenses also offer vision exams by licensed optometrists. For example, you can get an eye exam at many Costco, Walmart, Sam's Club and Target locations, or from retailers such as LensCrafters and Pearle Vision.

Before buying vision insurance, make sure you understand:

  • Exclusions and limitations
  • What the plan covers and what you'll pay out of pocket
  • How often you can use your benefits
  • If you must use an in-network eye doctor
  • Whether the insurance reimburses you or pays the provider directly

The key consideration in buying vision insurance is whether the amount you could save outweighs the cost. Someone with the EyeMed Enhanced plan could save $120 on progressive lenses compared with the Standard plan, for example. However, the Enhanced plan costs an additional $219.84 annually—and you'll pay that amount even if you don't use the plan that year.

Do You Need Vision Insurance?

Those with no vision problems or family history of eye disease may not need vision insurance. If you're concerned about vision coverage for your children, check your health insurance plan benefits. Even if vision insurance is not included in the plan, any plan that's compliant with the Affordable Care Act must cover children's vision care until age 19 (although there may be copays, coinsurance or deductibles involved).

Whether or not you have vision problems, the American Academy of Ophthalmology recommends getting a comprehensive eye exam by an ophthalmologist at least once during your 20s, twice in your 30s and again at age 40 (when certain vision problems first appear). After 55, you should be examined every one to three years. Eye exams can detect other health concerns, such as diabetes, heart disease and high blood pressure.

If you're not sure whether you need insurance but want to have your eyes tested, you can get an eye exam without vision insurance. Check the cost of eye exams at retail locations in your area. You can also contact local optometrists and ask if they offer a "cash price" for patients without vision insurance; this can be significantly less than what insurance companies pay.

There are other ways to save money on corrective lenses. Use a flexible spending account (FSA) or health savings account (HSA) to save money tax-free for qualified medical expenses, including corrective lenses. You can also save on eyeglasses and contacts by shopping at online-only retailers and watching for sales or discounts.

Will Vision Insurance Providers Check Your Credit?

Insurance carriers sometimes use insurance-based credit scores when pricing auto or home insurance. These scores help predict the likelihood you'll file a claim. Generally, a credit check is not required for health insurance; however, it's always wise to maintain good credit. Not sure what your credit score is? Check it for free with Experian. While a good credit score may not affect your vision insurance premiums, it can make your financial life easier in many other ways.