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Vision Coverage–Do The Math

I had a patient come into my office for a contact lens exam recently. As usual we asked if he would be using any insurance. His answer floored me because I have not ever heard a patient say this.

He said “It is less expensive to just pay for the exam than use vision insurance.”

The vision plan covers the determination of a prescription for glasses and a wellness check up. The wellness checkup is to look at the eyes to make sure they are healthy. Many of my patients tell me the last doctor did a “really fast exam”—-that is what vision plans pay for.

Sometimes that is all the patient needs. Most times there is an ocular health condition coexisting with a vision problem. That is why when patients come into my office we check the medical insurance. If there is any ocular disease that needs to be managed, it is not covered by a vision plan but by the medical plan.

What if you are like my patient above who has no ocular health problems and just needs his yearly contact lens exam? What do you do? Do the math. Figure out cost of the exam and glasses. Compare it to how much you are paying for a “free” exam and glasses,if applicable factor in any copays. Consider using your health savings account to pay these costs. In the case of my patient, his premium for vision coverage would have been $50 per month (and he still had various copays). That’s $600 per year. (This is the highest premiums I have heard of to date) His out-of-pocket costs for exam and contact lenses will be less than $450. He saved himself $150 by opting out of the vision insurance!

Regarding the eyeglasses, although I do not sell them I know that there are really good deals on eyeglasses at some opticals. I have seen a complete pair of single-vision glasses advertised for $38. Another advertisement offered a frame and bifocal lenses for $99. But even if you spend a few hundred dollars, if you divide the cost over the 18- 24 months that you will use the glasses then it usually comes out to less than a dollar per day for clear, comfortable vision.Some patients complain about spending $500 on a designer frame with no-line bifocals that change to sunglasses (transition lenses). However, they have had daily use of these glasses for 18 months. $500 divided by 547 days of good vision equals 91 cents per day. Not a bad deal for being able to see well to drive, read, use the computer, etc.

So again, do the math regarding your election of vision insurance. Maybe I won’t be so surprised at your answer to our question whether you will using any insurance……………