Good Eyecare Coverage: Vision Insurance vs. Medical Insurance

Navigating eyecare expenses can sometimes come with a few surprises. Don’t be caught off-guard at a visit with an ophthalmologist or optometrist. Our primer helps break down various eyecare costs and which ones—like paying for new glasses or contacts—are likely to be covered by medical or vision insurance.

By

Sally Wadyka

| Reviewed by

Cindy Cork, OD

Even if you have good health insurance, a visit to your eyecare provider can sometimes come with a surprise bill. That’s because traditional medical insurance only covers medical expenses (eye diseases or injuries) not routine, preventive eyecare. Vision insurance—which is typically a separate policy—is a wellness benefit you can use for general eyecare.

 

What types of eyecare does medical insurance cover?

Medical insurance, as the name implies, is designed to cover expenses related to medical conditions. That means it will cover eye diseases and injuries—but not routine eye exams, contact lenses or a new pair of glasses. In order to use these benefits, you can visit an ophthalmologist (who is a medical doctor) or an optometrist. Learn more about which one may be right for you. 

 

In terms of eyecare, your medical insurance should cover things such as:

  • Chronic eye conditions, including glaucoma, macular degeneration, dry eyes, cataracts and diabetic retinopathy
  • Eye injuries
  • Eye infections
  • Eye surgery
  • Certain types of laser surgery (most insurance does not cover LASIK, laser vision correction)

 

What types of eyecare does vision insurance cover?

Vision insurance helps defray the cost of preventive vision screenings. It can also help pay for all or some of your vision correction needs—like contacts or prescription glasses. Many optometrists and ophthalmologists accept vision insurance for eye exams, contacts and glasses.

 

Should I add vision insurance to my coverage?

If you wear contacts or glasses, it may make sense to add vision insurance to your healthcare policy. In many cases, premiums are only about $10 per month for vision insurance that will cover eye exams and vision care. Most policies cover the costs of standard contact lenses or will offer a discount off premium lenses (such as multifocal or daily wear). If you wear glasses, your policy may also cover a portion (if not all) of the cost of new frames and prescription lenses. 


Vision insurance plans differ. Some policies will cover all your eyecare expenses up to a specific dollar amount. Others only provide a discount on eyecare services--such as 20 percent off covered visits and products. 


The best way to ensure that vision insurance will make sense for you is to take a close look at what your policy will cover. Then estimate the annual cost of your premium (individual and family plans will differ) and what you expect to pay for your eyecare exams, glasses or lenses during that period. 

 

The advantages of vision insurance can go beyond cost savings. If having vision coverage means you stick to your recommended schedule of eye exams and prescription updates, you could also protect your eye health. Regular screenings help detect the early stages of eye disease. And updating your prescription annually means you’ll never have to wear your contacts longer than recommended (which increases your risk of serious eye infections). 

 

The QE Perspective

Your eyesight is too important to ignore, which is why you should never put off preventive eyecare. Check your policy to see what your medical insurance covers. If you need routine screenings and vision exams, you may want to consider adding vision insurance to your healthcare coverage. In most cases, the cost of the premium is offset by the discounted eye exams, contact lenses and prescription glasses. 


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Taking good care of your eyes and your overall health can go a long way toward preventing age-related eye conditions. Eating an eye-healthy diet that includes lots of antioxidant-rich fruits and vegetables slows down the formation of cataracts and reduces your risk of macular degeneration. Getting plenty of exercise and maintaining a healthy weight can prevent diseases like diabetes and high blood pressure--both of which affect vision and eye health. And while you may not be able to prevent the presbyopia (and need for reading glasses) that comes with getting older, your eyecare professional can make sure you get the correct vision correction to see clearly.

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The sun’s rays contain damaging ultraviolet (UV) light. The same UV rays that burn your skin and lead to skin cancer also affect your eyes. Staring directly into strong sunlight can damage the retina. And repeated sun exposure over time can lead to cataracts, benign growths on the eyes and even eye cancer. Protect your eyes anytime you’re in the sun by wearing sunglasses that block both UVA and UVB rays.

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Some people claim that by correcting your vision with prescription glasses or contacts, you’re weakening your eyes—which then leads to worse vision. Their “proof” is that after wearing your corrective prescription for a while, your vision appears blurrier when you’re not wearing it. But that’s likely because you’re now used to seeing the world in clear, crisp detail—and in contrast, your uncorrected vision appears fuzzier. Getting the proper vision correction for your eyes is essential for your eye health. Don’t try to tough it out if you can’t see clearly. Visit your eyecare professional for an in-person or virtual vision screening.


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Not having a bright enough light may make it harder to clearly see the words on the page, but it won’t damage your eyes or permanently impact your vision. Because you’re straining to see, you might get a headache or other symptoms of eyestrain. If you want to read in bed without illuminating the entire bedroom, get a reading light that provides just enough brightness to see your book clearly. 


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LASIK surgery corrects your distance vision only, so people who are nearsighted benefit most from it. But LASIK doesn’t affect the lens of the eye, the part that helps you focus up close. As you get older, changes to the lens impact your ability to see close up. So even if you have LASIK in your 20s or 30s, you’ll most likely still need reading glasses by the time you hit your 40s or 50s.

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Having your face right up next to the bright screen may give you a headache or even cause some temporary eyestrain or fatigue, but it won’t damage your vision. Children are more prone to this behavior than adults—which may be because children can focus close up better than adults can. But if your child can only see the television clearly when sitting close (and has to hold other things close to see them clearly), they may be nearsighted. Taking your child to an eyecare professional for a vision exam will help determine if they need glasses to see clearly.

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Most eyecare professionals recommend removing—and thoroughly cleaning—your contacts every night. Even if you use extend-wear lenses that are approved for use a week or month at a time, it’s always safer to give your eyes a nightly break. Your contacts are more likely to accumulate bacteria when you leave them in 24/7, and that can lead to eye infections. Sleeping in your contacts also prevents essential oxygen from getting to your corneas. If you must sleep in your contacts, make it a once-in-a-while event and ask your eyecare provider about contacts that are specially formulated to let more oxygen through. 


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Carrots (along with other vegetables like sweet potatoes and dark leafy greens) contain high amounts of beta-carotene, which the body converts to vitamin A. Vitamin A is essential for eye health, and a deficiency of the nutrient is the leading cause of childhood blindness in developing countries. In the U.S., vitamin A deficiency is rare, and few people get so little it could impact their eyesight. Also, there’s no evidence that beta-carotene affects the sharpness of your vision or can prevent near or farsightedness. So while getting lots of beta-carotene in your diet may help keep your eyes healthy, no amount of carrots is going to actually improve your vision and allow you to toss out your glasses or contacts. 


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The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer.

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The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer. 


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