Vision insurance plans don't have to be confusing. Jeff Spahr, Staff Vice President of Visions Services for Wellpoint, reveals the basics of vision plans as well as some tips for finding the best coverage.
An Interview with Jeff Spahr, of Vision Services at Wellpoint
What is a vision insurance plan?
It provides coverage for routine, preventive eye care such as eye exams, eyewear and other services at a reduced cost. Benefits may vary depending on certain state regulations and plan designs.
What expenses are usually covered?
Most vision plans cover an eye examination as well as eyewear, such as contact lenses or eyeglasses. These benefits are generally offered every 12 or 24 months.
Is vision coverage usually included in health insurance plans that are issued through employers?
Comprehensive vision care benefits - including an exam and the necessary eyewear - are not typically included in a health benefits plan, which is why vision coverage is so important. Vision benefits have actually increased in popularity over the years as more employers recognize that proper vision care is an important part of a comprehensive health benefits package.
Is it difficult to obtain individual vision insurance instead of through an employer?
Individual vision insurance is available; but, it is generally more affordable to get coverage through an employer, even if it is offered on an employee-paid (voluntary) basis.
How can someone save money on vision insurance?
With an employer-sponsored plan, people can typically save money by visiting in-network providers. These providers have contracted with the plan to offer savings to plan members.
If their employer doesn't offer a vision insurance plan, they might think about contributing to a flexible spending account (FSA). FSA accounts allow you to use pre-tax dollars for health related costs, like eligible vision care expenses. You can save money by using the FSA because you can set aside that money for health-related costs and it won't be subject to income taxes.
Always consult with a tax professional for specific FSA tax benefits.
How does vision insurance differ from a vision discount plan?
Vision insurance typically provides members with eye care services in exchange for an annual premium. Vision plans may also have a yearly deductible and a co-pay each time a member uses their benefits.
A discount vision plan gives members vision benefits at fixed rates. Members have access to these fixed rates after they pay a membership fee/annual premium, along with a deductible.
What should people look for when shopping for a vision plan?
Some of the key benefits people should look for in a vision plan include:
- Coverage from an experienced, well-respected company
- Benefits for an annual eye exams, including dilation
- Benefits for eyeglass frames and lenses
- Contact lenses
- Discounts on LASIK vision correction
Some plans also offer discounts on non-covered materials like extra pairs of glasses, conventional contact lenses, lens treatments and specialized lenses.
People should also look at the size of the plan's network. They should be sure that the network offers plenty of options for providers in their area. Another great benefit is in-network retail locations. Many retail locations offer convenient evening and weekend hours, with some filling orders in as little as an hour.
Are contact lenses included within most vision plans?
Most vision plans do cover contact lenses although it is common for the plan to cover either frames/lenses or contact lenses in any one plan year.
Why should people pay the expense of having a vision plan?
Having a comprehensive vision plan can help defray out-of-pocket expenses for routine eye exams, frames, contacts and other vision needs. Additionally, saving money on vision care expenses increases the chance that people will continue to receive routine vision care. Many people don't know that regular eye exams are important to overall health because eye exams can offer a glimpse into major health conditions, like diabetes, high blood pressure and cardiovascular disease. Eye diseases often have no warning symptoms, so many people don't realize they are at risk for impaired vision or blindness, according to organizations like the National Eye Institute and Prevent Blindness America.
Even if your vision seems normal, there are advantages to having an eye exam on a regular basis. Eye diseases such as glaucoma (internal pressure in the eye which causes damage to the optic nerve) and macular degeneration (changes in the retina that result in the gradual loss of central vision) can develop without any warning. Cataracts can also form well before you have any noticeable symptoms. Other health conditions that may be detected during an eye exam are diabetes and high blood pressure.
It is recommended that people schedule an eye examination at least every two years, and every year for those over the age of 65 or with diagnosed medical conditions.
About Jeff Spahr
Jeff Spahr is responsible for the planning and strategic direction of WellPoint's vision product, which currently serves 2.5 million members.
Since joining WellPoint in 2001, Spahr has served in a number of different roles, including manager of Planning and Development for WellPoint's Specialty Products, as well as Finance Manager. He has also participated in several key enterprise-wide finance initiatives.