What Is Vision Insurance and How Does It Work?

Keeping an eye on your vision health is crucial because in the United States alone, more than 150 million people have a refractive error.¹ Additionally, 1 million Americans are legally blind.² Regular visits to your eye doctor are essential for early detection of vision issues, allowing you to safeguard your sight.

However, vision care can be costly (a new patient consultation averages $167)³ and this is where vision insurance steps in to save the day. Unlike regular health insurance, vision insurance specifically covers eye-related costs and helps offset expenses related to eyewear and eye care that your standard health insurance may not cover.

Here, we'll delve into what vision insurance entails, how it works and what you can expect regarding costs.

What Is Vision Insurance?

Vision insurance is a type of insurance — not a discount plan — that specifically covers eye-related expenses such as corrective lenses, eye exams and eye surgery not covered by your health insurance.⁴ It is a policy that is separate from your health insurance, with its own premiums, deductibles, copays and network of doctors.

How does vision insurance differ from health insurance?

Health insurance covers all of your health-related expenses, including injuries or disease-related problems with your eyes. Some plans may offer vision coverage, which pays for a portion of your nonmedical vision care expenses like glasses and contacts. Unlike health insurance, vision insurance only covers nonmedical eye care expenses.⁴

Note that all health plans for sale on the Health Insurance Marketplace® offer vision coverage for children.⁴ Only some plans may offer vision coverage for adults.⁴ That's where vision insurance can step in and cover preventative and elective vision-care expenses — like laser-assisted in situ keratomileusis (LASIK) surgery — which typically aren't covered by your health insurance.

What does vision insurance cover?

Vision insurance covers costs related to the maintenance of your eye care. These costs include:⁵

• Eyeglass frames
• New patient eye doctor costs
• Prescription contacts
• Prescription lenses
• Routine eye exams

In most cases, vision insurance may cover vision-related medical procedures related to your health, such as surgery to treat glaucoma, macular degeneration or cataracts.⁶ However, for elective procedures like photorefractive keratectomy (PRK) or LASIK, which costs an average of $2,981 for both eyes,³ your health insurance typically won't apply.⁷ Vision insurance usually covers a portion of these expensive procedures to save you money.⁵

Who should get vision insurance?

Vision insurance is appropriate for people of all ages, especially those who wear corrective eyewear. It ensures that even if you aren't suffering from any vision problems, you can maintain the health of your sight. That's because regular exams can help catch any eye issues early on.

Many plans offer family options to cover everyone in your household. For older adults, some plans work with organizations like AARP to provide vision insurance plans at a discount.

Keep in mind that everything from digital screens to UV light can take a toll on your eyes over time, not to mention the chances of accidental eye injury just from walking around. That alone makes vision insurance a great investment for everyone.

How Does Vision Insurance Work?

Like health insurance, vision insurance plans require you to pay a monthly or annual premium, which applies whether you use the plan or not. This allows you to apply the plan's benefits to your eye care costs.

Can I use any eye doctor for my eye care?

Whether or not you can use any doctor will depend on the policy you purchase. Most policies only pay for services rendered by doctors within their network and cap benefits for corrective eyeglasses and contacts.

For example, many plans will cover the majority of costs for eye care expenses for an in-network doctor, often offsetting the cost of a standard eye exam ($136 on average).³ Additionally, they may allow a certain amount for eyeglass frames, for instance, from any eye doctor or eyeglass retailer within their network.⁵

How does payment for eye care work?

In-network doctors will typically file your claim paperwork for you and charge you for the copayment, coinsurance cost or deductible required at the time of your service. If you visit an out-of-network doctor, you'll pay for all of your services up front and then submit your receipts to your vision insurance provider for reimbursement of the allowable expenses, usually at a lower rate than an in-network provider.⁵

Do vision plans differ in terms of benefits?

Yes, different vision care plans have varying copayment amounts for doctor visits and usually only pay up to a certain amount for glasses or contact lenses. For example, your plan may require a $35 copay for doctor visits and pay up to $126 for eyeglass frames.³

Note that most plans pay for only one routine eye exam and one pair of eyeglasses per calendar year. The plan may also have limits on the amount of money allowable toward your annual contact lens expenses, including disposable contact lenses. However, some plans offer a discount on additional pairs of eyeglasses purchased within the year.⁵

Not all plans offer benefits for LASIK surgery, but some plans do.⁵ Be sure to ask your insurer before choosing a plan if this procedure is something you are thinking about getting.

How Much Does Vision Insurance Cost?

The national average cost* of a vision insurance plan is $20 per month but can range from $16 to $38 depending on the provider, coverage type and plan options.³ Plans that cost less usually have higher deductibles and copays than more expensive plans.

Average cost of vision insurance by state/district

The cost of vision insurance can also vary based on your geographic location. Below is a breakdown of the average cost* per month of vision insurance by all 50 states and the District of Columbia.³

Where can I purchase vision insurance?

Vision insurance plans are offered through insurance brokers, online vision insurance companies and employers. You may also find them on your state's health exchange for purchase along with a healthcare plan. However, standalone vision care plans are not sold on the Health Insurance Marketplace.⁴

How can I pay for costs not covered by vision insurance?

To bridge the gap and pay for vision care expenses not covered by your vision insurance — such as copays, coinsurance costs and deductibles — you can use your CareCredit credit card at locations in the network and pay over time for these expenses.**

Is Vision Insurance Worth It?

Consider vision insurance as important as health insurance to maintain your sight. Most plans are reasonably priced, and they allow you to practice preventive eye care with regular visits to your eye doctor. These visits are important because they can catch problems like glaucoma or cataracts before they become too serious.

While the cost of your eye care may vary based on where you live and your eye health, vision care expenses can include significant out-of-pocket costs, including:³

• Cataract surgery, which averages $4,401 for a single monofocal lens
• Contact lenses, which average $60 for a 30-day supply
• Eyeglass frames, which average $218 for an average pair
• Glaucoma surgery, which averages $3,393 for a minimally invasive procedure

With vision insurance, you'll pay substantially less for these costs. This is cost-effective if you wear corrective lenses or contacts. But even if your vision is perfect, it can help you detect problems early, making vision insurance a worthwhile investment in your health.

Financing Eye Exams With the CareCredit Credit Card

Regular eye exams are an important part of your eye health. Whether you’re getting an eye exam or paying for eye surgery, the CareCredit credit card can help you pay for care where your insurance leaves off.** Use our Acceptance Locator to find a vision specialist near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to vision care, you can also use your CareCredit credit card for dentistry, cosmetic, pet care, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Susan Paretts is a freelance writer with 20 years of experience covering health and wellness, pet care and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, The San Francisco Chronicle, Chewy and more.