What does vision insurance typically exclude?

What does vision insurance typically exclude?
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Ameritas: the best for families

Founded in 1887 and originally called The Old Line Bankers Life Insurance Company of Nebraska, Ameritas serves more than four million customers and has received high ratings from AM Best and Standard & Poors. Plans are available nationwide, and there are no waiting periods. Wait.  

Ameritas offers two tiers to its plans, which are affordable for families, starting at $23.47 per month. All levels provide free eye exams every 12 months (covered in total). Still, the lower tier only offers contacts or eyeglass lenses and frames every 24 months, a $25 eye exam deductible, and a $130 allowance for frames or contacts. The higher tier offers a lower copay for eye exams at $10 and a $150 budget for frames or contacts every 12 months.

What is vision insurance?

Vision insurance is a supplemental health insurance plan to help lower your vision-related expenses. These plans will cover some products and services, such as glasses and eye exams; additional benefits may differ between insurers.  

Whether you purchase an individual project or as an optional rider with your regular health insurance, these plans are best for those who have recurring vision expenses, such as buying contact lenses regularly or those who require an annual eye exam. Plans may have copays or deductibles: copays are a set amount you pay out of pocket before your insurer covers the remaining balance. At the same time, a deductible is an amount you’ll need to pay each year before your vision insurance is activated. 

For example, if you have a $10 copay for eye exams, that’s all you have to pay when visiting your eye doctor. Your insurance will cover the rest. Whereas if you have a $300 deductible, you’ll need to spend that amount on any qualified expenses within a calendar year before insurance pays for what’s covered in your vision plan.

Even those planning to undergo LASIK or similar eye surgery may find vision insurance helpful. That’s because you can save a significant amount of money compared to paying your vision expenses out of pocket. LASIK is not covered by regular health insurance, so vision insurance may offer a discount on services if you are using an in-network doctor.

What does vision insurance typically include?

Vision insurance plans include benefits that can help you detect eye disease or severe vision problems early and make maintaining good vision a little more affordable. This includes costs related to contacts, glasses, and annual eye exams. Also, many plans offer discounts for LASIK procedures—health insurance doesn’t necessarily cover it because it’s not considered medically necessary.

Visits with in-network doctors may require prior authorization before your exam. At the same time, for out-of-network, you may need to pay upfront and submit receipts for reimbursement, assuming your provider covers it.

What does vision insurance typically exclude?

Vision insurance plans do not cover the treatment of eye diseases, which are usually covered by your regular health insurance plan. In other words, health insurance generally covers eye care related to a medical condition. If you have eye complications from diabetes, are diagnosed with high blood pressure, or have cataracts, your health insurance may cover vision care. At the same time, vision insurance may take care of the eye exam if your health insurance doesn’t.

What are the expected costs of vision insurance?

Monthly premiums from the companies listed above are relatively cheap, averaging around $10 for the lower tier plans. All plans include an annual eye exam and allowances for glasses or contacts, although the amount allowed and copayment amounts differ among insurers.

You can expect to pay more, some as high as around $30 a month, for higher levels of coverage. Companies with higher-tier plans typically include:

  • A larger eyeglass and contact lens allowance.
  • Lower copays.
  • Additional discounts on other products and services (such as LASIK surgery).

Is it worth paying for vision insurance?

Maintaining eye health is crucial to your overall health. For example, during routine eye exams, doctors can detect serious health problems. Such as high cholesterol, diabetes, autoimmune diseases, high blood pressure, and some types of cancer. Getting an early diagnosis could mean lower overall costs for medical treatment.

Even something as simple as visual impairment can affect your everyday life. Think about mobility, regular communication, and even your independence. Undiagnosed visual impairment can hamper their long-term health and academic and social performance for children.

Plus, paying for the view can be worth it from a cost-savings perspective. If your vision care needs exceed the cost of insurance. Then it might be a good idea to consider getting some form of coverage.

For example, your vision insurance premium costs you $124 each year. A basic eye exam can cost around $100, but you only pay a $10 copay. You discover that you need new glasses, which cost you $200 for the pair with standard lenses. You have to pay $50 since you only get a $150 allowance. That means you only pay $184 per year (including your copay and the amount above your budget). Instead of the $300 it would cost without insurance, saving you $116.

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