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Home » Education Blog » Health Insurance Vs. Vision Plans: Which One Should You Use?

Health Insurance Vs. Vision Plans: Which One Should You Use?

If you haven't read my previous two articles on this series, you can find them on our Facebook page or our website. Those articles address the difference between optometrists and ophthalmology as well as what constitutes a full eye exam. The focus of those articles was to help you understand how to get more appropriate care based on your need (article 1) and how to make sure you are getting the most adequate care for what you pay (article 2). The purpose of this article is to clarify an issue we encounter on a daily basis with our patients, the purpose and function of vision plans. Numerous patients who present with an acute or chronic medical issue affecting their eyes frequently tell us "Doc, I didn't come in sooner because I don't have eye insurance.”

Pensive woman with glasses

Let me be very clear on this issue. When we're dealing with annual visits for glaucoma, diabetes, macular degeneration, or any kind of medical condition that happens to be affecting the eyes, we charge your MEDICAL INSURANCE. A vision plan is simply to help cover the cost of the refraction ("better with one or two") and the purchase of glasses or contact lenses.

It's very important to understand that vision plans are NOT insurance. Vision plans work more like a COSTCO membership. You pay for a "membership" and with that membership comes discounts toward refraction fees and the purchase of materials. However, when you take into account the limitations placed on how you spend your money by restricting what or when materials can be purchased, and that on average you only qualify for a complete pair of glasses once every two years the question remains whether you are really saving money? Do these companies have your best interest in mind? The downside of so many vision plans is that they are designed to allow you to use the materials that gives them more profit, regardless of the quality you are getting. Doctors are also being driven to see an average of three times more patients because vision plans continually decrease the amount they compensate doctors toward your refraction and materials. This in turn greatly affects the quality of your visit.

Our goal is to help you truly understand how to best utilize your medical insurance and vision plan policy to your best advantage. It's quite simple actually, if you have a medical condition that is affecting your eyes, the office will bill your medical insurance for an annual routine visit and any additional visits for further testing of this medical issue. If you carry a vision policy, we will submit the claim for the materials on your behalf and you will receive a refund for what they allow you. This method allows you more savings from the doctor being able to lower their prices on one end and the insurance giving you money back on the other without compromising the quality of your materials or the eye exam. Another option is to simply cancel the vision plan, put the same amount of money into a savings account and ask your doctor for the "prompt payment price" for services and materials. You will save considerably more altogether.

And as you shop around, make sure to compare apples to apples so you don't compromise the quality of the services and materials you are purchasing. Remember the saying that there's no such thing as free lunch... well, those amazing online or doc-in-a-box deals for glasses have a catch... you pay less because they sell discontinued frames without any warranty, their lens technology is from 20-30 years ago and you only spend 5-10 minutes with the doctor.

Follow us on social media or our website to follow our promotions. See you on your next eye exam!

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