Maximizing Vision Insurance Benefits For Eyeglasses

Vision insurance can help reduce the cost of prescription eyewear, including eyeglasses, and contact lenses. The process of billing for vision insurance eyeglasses depends on whether you are the patient or the optometrist. As a patient, you can either pay out of pocket and then apply for reimbursement from your insurance provider, or you can shop at an in-network retailer and have them bill your insurance provider directly. As an optometrist, you will need to verify the patient's insurance plans before the office visit and select which plan to bill based on the patient's chief complaint and diagnosis.

Vision insurance can reduce costs for prescription eyewear

Vision insurance can significantly reduce the cost of prescription eyewear. It is a specialized type of coverage that helps individuals manage their eye care expenses. Routine eye care, such as annual eye exams, is often not covered by health plans, but vision insurance can help cover some of the costs.

Vision insurance typically covers the cost of eye care services such as routine eye exams, prescription eyeglasses, and contact lenses. Some plans may also offer discounts on elective vision correction surgery, such as LASIK. However, it's important to note that vision insurance plans usually only offer discounts for an annual premium, and do not provide unlimited benefits like medical insurance.

The amount of savings generated by vision insurance depends on the plan chosen and the individual's specific needs. Basic vision insurance plans typically include some coverage for prescription eyewear, such as one pair of eyeglasses per year. More comprehensive plans may include additional benefits such as anti-reflective coating or photochromic lenses.

Vision insurance can be purchased as a group benefit through an employer or as an individual policy. The cost of vision insurance varies but typically ranges from $5 to $35 per month for an individual. It is important to review the specific benefits and limitations of each plan before purchasing to ensure it meets your needs.

In addition to vision insurance, some individuals may also use flexible spending accounts (FSAs) or health savings accounts (HSAs) to offset the cost of prescription eyewear. These accounts allow individuals to use pre-tax dollars to pay for qualified health expenses, including prescription eyeglasses and contact lenses.

You can use an itemized receipt to claim reimbursement from your insurance provider

If you have an out-of-network benefit included in your insurance plan, you can apply for reimbursement on prescription eyeglasses or sunglasses and eye exams.

To apply for reimbursement, you will need to complete an out-of-network claim form, which you can download from your insurance company's website. You will then need to attach an itemized receipt to the form. This receipt should show a breakdown of the costs of each component of your glasses, such as the frames, Teflon coating, edge polishing, and other parts. You can usually request an itemized receipt from the retailer where you purchased your glasses.

Once you have completed the claim form and attached your itemized receipt, you can submit the documentation to your vision insurance company. After submitting your claim, you will typically receive reimbursement within 2-3 weeks, depending on your provider.

It is important to note that most major insurance providers will split the charge 50/50 between frames and lenses. Additionally, some insurance plans may have limits on how much they will cover for frames and lenses. Therefore, it is recommended that you check with your insurance provider to understand what costs are covered before purchasing your glasses.

Some online eyewear retailers accept vision insurance

Several online eyewear retailers accept vision insurance. If they don't, they should provide the documentation you need to request reimbursement from your insurance after paying out of pocket.

• LensCrafters: EyeMed, Aetna, Humana, Blue View Vision and more
• Ray-Ban: Eyemed, Aetna Vision Preferred, Blue View Vision, Humana Vision and UniView Vision and more
• Target Optical: EyeMed, Aetna, Humana, Blue View Vision and more
• Eyeconic: VSP, MetLife, Cigna Vision
• Glasses.com: EyeMed, Anthem, Aetna Vision Preferred, Humana Vision and more
• ContactsDirect: EyeMed, Aetna, Humana, Blue View Vision and more
• 1-800-Contacts: Davis Vision, Superior Vision (Versant Health), Blue View Vision/Anthem BCBS

Online eyewear retailers who aren’t affiliated with any vision insurance providers often will walk you through the process of getting reimbursed by your vision insurance company. These include:

• SmartBuyGlasses: You can claim reimbursement using an itemized receipt upon purchasing your prescription eyewear or contact lenses with your insurance provider.
• Warby Parker: Accepts insurance from major providers, including UnitedHealthcare, Aetna, Anthem, etc. If your provider is not listed, you will need to contact your insurance company directly for reimbursement.
• YesGlasses: Accepts HSA and FSA affiliated with a major credit card. For all other insurance, YesGlasses provides a detailed copy of an invoice for your provider.
• Overnight Glasses: Accepts FSA/HSA dollars for prescription eyewear. For all other insurance, Overnight Glasses provides a detailed copy of an invoice for your provider.
• Covry: Accepts HSA and FSA affiliated with a major credit card. For all other insurance, Covry provides a detailed copy of an invoice to submit for reimbursement.
• Roka: Accepts FSA/HSA dollars and several major insurance providers including Aetna, Ameritas, Blue Cross Blue Shield, Cigna, EyeMed, Humana, United HealthCare, and VSP. For all other insurance, Overnight Glasses provides a detailed copy of an invoice for your provider.
• Pair Eyewear: Accepts FSA/HSA dollars affiliated with a major credit card. For all other insurance, Pair Eyewear can provide a detailed copy of an invoice to submit for reimbursement.
• Felix Grey: Accepts FSA/HSA dollars for prescription eyewear.
• SportRx: Accepts FSA/HSA dollars and several major insurance providers including Aetna, Cigna, EyeMed, Humana, Spectera, DavisVision, United HealthCare, and VSP. For all other insurance, SportRx provides a detailed copy of an invoice for your provider.
• Zeelool: Accepts HSA and FSA dollars affiliated with a major credit card. For all other insurance, Zeelool can provide a detailed copy of an invoice to submit for reimbursement.
• DIFF: Accepts FSA/HSA money affiliated with a Visa or Mastercard. If you don't have one of these debit cards, you can get an invoice from DIFF to submit to your provider.

Note that because these retailers aren’t affiliated, they will likely be considered out-of-network by your insurance company. So, if you are reimbursed, it will not be for as much as if you had made your purchase from a preferred online provider.

Vision insurance covers eye examinations

Vision insurance typically covers eye examinations, but there are some important nuances to be aware of. Firstly, it's important to differentiate between medical and vision insurance. Medical insurance covers ophthalmologist visits for medical issues with your vision that require a physician's treatment and prescription medication. On the other hand, vision insurance covers visits to the optometrist and may also cover some treatments provided by an ophthalmologist.

When it comes to eye examinations, vision insurance usually covers routine eye exams for vision correction purposes, such as obtaining a prescription for glasses or contact lenses. However, it's worth noting that some vision insurance plans only cover eye examinations once per calendar year. Additionally, certain vision insurance plans may only cover either glasses or contacts during the same benefit period, so it's important to check the specifics of your plan.

The type of eye examination you undergo and your reason for visiting an eye doctor are the main factors in determining whether your insurance covers the examination. For example, routine eye exams typically lead to diagnoses like astigmatism or nearsightedness, while medical eye exams can result in diagnoses such as conjunctivitis.

If you have out-of-network benefits included in your insurance plan, you can often apply for reimbursement for eye examinations and prescription eyewear. The reimbursement process usually involves submitting an out-of-network claim form along with an itemized receipt to your vision insurance company.

It's also worth noting that vision insurance plans vary in what they cover. Some plans may only cover basic lenses and frames, while others may offer discounts on specialty options like anti-reflective coatings or progressive lenses. Therefore, it's important to carefully review the specifics of your vision insurance plan to understand what is and isn't covered.

Vision insurance can be purchased as a group benefit through your employer

Group vision insurance typically covers routine eye exams, glasses, and contact lenses. Some plans may also offer discounts on laser eye surgery procedures, prescription sunglasses, and eye care for major medical problems. The cost of group vision insurance is usually relatively inexpensive, often costing less than $10 per employee per month.

When deciding whether to purchase group vision insurance, employers should consider the needs of their employees and the level of coverage they want to provide. It is also important to compare the policy's total annual cost to the anticipated annual vision care expenses of employees to ensure that the benefits outweigh the costs.

Additionally, employers can choose to include vision benefits in their health insurance plan or select a standalone vision insurance carrier. They can also opt to add vision benefits as a voluntary benefit, allowing employees to choose whether or not to enroll and pay for vision benefits.

Frequently asked questions