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Health Insurance, Vision Insurance or Both?

by | Dec 11, 2024

Are Your Eyes Covered?

Vision insurance is a good way to reduce eye care expenses, especially if you are among the millions of Americans with some degree of vision impairment. According to the CDC, the cost of eye care prevents about half of Americans from seeing an eye doctor. In most cases, lack of adequate health insurance kept individuals from seeking care.

If you have health insurance, your policy may cover some vision services. However, it is important not to make assumptions about what is covered. Contacting a health insurance agent who will help you review your policy can prevent surprise bills if you need services later.

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What Does My Health Insurance Policy Cover?

Your health insurance policy covers services that address medical conditions, including eye-related issues. For example, health insurance covers vision surgery for fixing a detached retinal or removing cataracts, but it does not cover routine eye exams and items such as glasses or contacts.

 

What Does Vision Insurance Cover?

Vision insurance pays for a portion of expenses such as basic preventative care, including vision tests and eye exams. It also covers eyeglasses, including the lenses and the frames, and/or contacts. Depending on your plan, there may be additional benefits, such as coverage for daily disposable contacts.

Vision insurance does not cover eye surgeries. If your optometrist notices a medical problem during your annual eye exam, they will refer you to a medical doctor, such as an ophthalmologist, for further evaluation. From there, your health insurance would pay for treatment if it were deemed “medically necessary”.

 

Does Insurance Cover Corrective Surgery?

Corrective surgery has become an increasingly popular choice for those with less-than-perfect vision. Despite its convenience and cost-saving benefits, corrective surgery is not medically necessary and is not covered by either your health or vision insurance. However, because it can ultimately save the insurance company money, many vision plans include discounts that may help you afford surgery.​

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Do I Need Both Health and Vision Insurance?

If you wear glasses or contacts, the benefits of vision insurance are obvious – annual eye exams can be pricy, and depending on your prescription and eye health, corrective lenses can be a significant expense.

However, even if you have perfect vision, you should not skip eye exams. These exams can detect hidden medical problems, including brain tumors, certain types of cancer, high cholesterol, high blood pressure, thyroid disease or vitamin deficiencies. If you are under 40, current recommendations are that you visit an optometrist every five to ten years. As you get older, more frequent appointments are recommended.

If occasional routine appointments are all you need, then you probably do not need vision insurance. However, if you have poor vision or a family history of eye disease or a condition like diabetes that increases your risk of eye disease, vision insurance can save you money.

 

Getting Vision Coverage with Nevada Insurance Enrollment

Vision insurance is generally affordable, but benefits and out-of-pocket costs vary widely. At Nevada Insurance Enrollment, our health insurance agents help you find the right plan for your needs.​

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What Happens If You Forget To Pay Your Premium By The Due Date?

Life happens, and while you should make every effort to pay your health insurance premium on time, health insurance plans generally will have grace periods. You may have a grace period of 30 days, or if your insurance plan is through Nevada Health Link (on-exchange), it may be up to 90 days.

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Why You Should Always Use an Insurance Agent

Insurance agents are licensed professionals who specialize in connecting people with the insurance policies that are right for them. They help the customers understand their coverage by studying all the insurance company’s policies and procedures.

 

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What is the Free Look Period in Health Insurance?

To help customers avoid buyer’s remorse, health insurance policies are required to offer a free-look period. If at any time during this period you find that you’re dissatisfied with your policy, you can cancel it and get your money back.

HRA vs Employer Sponsored Health Insurance

An employer-subsidized plan is a sensible option for employees. Not only does the employer pay at least 50% of the employee’s premium, but the remaining premium is tax-free and taken directly from the employee’s pay.

Saving Money on Health Insurance With Negotiated Pricing

The majority of health insurance companies have a contract with a network of hospitals and other providers. In this contract, there are negotiated rates for different services. This negotiated rate is generally lower and sometimes significantly lower than what a provider would charge someone who is paying out of pocket.

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