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Health Care Reform:

Health Insurance & Affordable Care Act

How to Choose Vision Insurance

What Types of Plans Are Available? continued...

Vision plans do not generally cover LASIK eye surgery or cosmetic services, although some do offer a discount on these options.

Discount vision plans. The fee for a discount vision plan is much lower than the monthly premium you'll pay for a vision benefit plan. The discount plans typically cover the same types of exams, lenses, and other products as vision benefits plans do. But they only give you a discount on these items -- usually between 15% and 35% -- rather than the more extensive coverage of costs in a vision benefits plan.

What Kind of Coverage Is Right for You?

To decide what kind of vision coverage you need, start by calculating how much you've spent on vision care over the past few years.

"If you have generally good eye health in your family and you don't spend much on eye care each year, you might consider a discount plan," Roberts says.

If you're spending more than a couple of hundred dollars a year on eye care, it's probably worthwhile to consider a vision benefits plan.

Questions you should ask yourself as you make a decision include:

  1. Is my eye doctor in the plan's network? If you don't have an eye doctor at the moment, is there an in-network provider within a reasonable distance from you?
  2. Do you need prior approval to go out of the plan's network for vision care? How much do you get reimbursed for out-of-network services?
  3. What are the monthly premiums for the plan?
  4. What are the co-pays required? Some plans may have lower monthly premiums, but higher co-pays.
  5. What deductible do I have to pay before coverage kicks in?
  6. What is the plan's frame allowance? If you have a preference for a more expensive style of frames, it might be worth it to spend more on a plan that has a higher level of coverage for frames.

"There are many more options for vision care plans now than there have been in the past," Roberts says. "As you're choosing a plan, remember that what is most important is for everyone to get a regular, comprehensive eye exam."

The American Optometric Association recommends that children get eye exams at age 6 months, age 3 years, before first grade, and every 2 years after that. Adults should get a comprehensive exam every 2 years until age 60. After 60, exams should be done every year. People at high risk for vision problems (such as children who were born prematurely, or people with diabetes) should get eye exams more often.

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