vision insurance Archives - Performance Eyecare

Eye Exams for Kids

Some experts estimate that approximately 5% to 10% of pre-schoolers and 25% of school-aged children have vision problems. According to the American Optometric Association (AOA), all children should have their eyes examined at 6 months, 3 years, and again when they start school. Children without vision problems or risk factors for eye or vision problems should then continue to have their eyes examined at least every two years throughout school.

Children with existing vision problems or risk factors should have their eyes examined more frequently. Common risk factors for vision problems include:

premature birth

developmental delays

turned or crossed eyes

family history of eye disease

history of eye injury

other physical illness or disease

The AOA recommends that children who wear eyeglasses or contact lenses should have their eyes examined at least every 12 months.

Eye Exams for Adults

The AOA also recommends an annual eye exam for any adult who wears eyeglasses or contacts. If you don’t normally need vision correction, you still need an eye exam every two to three years up to the age of 40, depending on your rate of visual change and overall health. Doctors often recommend more frequent examinations for adults with diabetes, high blood pressure and other disorders. That’s because many diseases can have an impact on vision and eye health.

If you are over 40, it’s a good idea to have your eyes examined every one to two years to check for common age-related eye problems such as presbyopia, cataracts and macular degeneration.

Because the risk of eye disease continues to increase with age, everyone over the age of 60 should be examined annually.

How much does an eye exam cost?

Eye exams are available in many settings so the fees can vary widely. Generally speaking, contact lens exams cost more than regular eye exams. Likewise, an additional or higher fee may be charged for specialized services such as laser vision correction evaluations.

Many insurance plans cover at least a portion of eye exam services. Check to see what your benefits are and which eye doctors in your area participate in your plan before you make an appointment. Then be sure to give your doctor’s office your insurance information to verify coverage.

What information should I take with me to my eye exam?

It’s important to have some basic information ready at the time of your eye examination. Bring the following items to your exam:

All eyeglasses and contact lenses you routinely use, including reading glasses.

A list of any medications you take (including dosages).

A list of any nutritional supplements you take (including dosages).

A list of questions to ask the doctor, especially if you are interested in contact lenses or laser vision correction surgery.

Medical or vision insurance card if you will be using it for a portion of your fees.

The cost of routine eye exams and prescription eyewear can be of real concern, especially for large families. In many cases, vision insurance can lower these annual expenses.

A vision insurance policy is not the same as health insurance. Regular health insurance plans protect you against financial losses due to unexpected eye injuries or disease. Vision insurance, on the other hand, is a wellness benefit designed to provide routine eye care, prescription eyewear and other vision-related services at a reduced cost.

Where can I get vision insurance?

Group vision insurance can be obtained through your company, association, school district, etc., or through a government program such as Medicare or Medicaid.

Also, as an individual, you have the option of purchasing your own vision benefit plan.

Vision insurance is often a value-added benefit included in indemnity health insurance plans, health maintenance organization (HMO) plans and plans offered by preferred provider organizations (PPOs):

Indemnity health insurance is traditional insurance, which allows policyholders to access medical providers of their choice.
An HMO is a group of healthcare professionals – doctors, laboratories, hospitals and the like – employed to provide health care services to plan members at discounted rates. Usually, health plan members are required to access health care only from HMO providers.
A PPO is a network of healthcare professionals organized to provide healthcare services to plan members at a fixed rate below “retail” prices. Plan members may opt to access out-of-network providers, but usually at a greater cost.

What kinds of vision insurance plans are available?

Vision insurance typically comes in the form of either a vision benefits package or a discount vision plan.

Typically, a vision benefits package provides enrollees eye care services in exchange for an annual premium or membership fee, a yearly deductible (a dollar amount) for each enrolled member and a co-pay (a smaller dollar amount) each time a member accesses a service.

A discount vision plan provides eye care at fixed discounted rates after an annual premium or membership fee and a deductible are paid.

Both kinds of vision insurance can be custom-designed to meet the different requirements of a wide range of customers, including school districts, unions, and big and small companies.

What does vision insurance cover?

Vision insurance generally covers the following services and products:

Annual eye examinations
Eyeglass frames
Eyeglass lenses
Contact lenses
LASIK and PRK vision correction at discounted rates

Generally, services acquired from network providers are cheaper than services from out-of-network providers.

What are my payment options?

Typically, if group vision insurance is available from your employer, you pay for it through payroll deductions or flexible spending accounts (FSAs).

An FSA, sometimes called a cafeteria plan, allows an employee to use pre-tax dollars to purchase selected health benefits such as vision insurance. You save money because you receive the full benefit of income that has been set aside for health costs, making it not subject to or reduced by taxation.

If you purchase an individual vision insurance plan because your employer doesn’t offer a group plan (or because you are self-employed), you can expect to be billed monthly or annually.

For more information on vision insurance, visit All About Vision®.

Preparing for an Eye Exam

Eye Exams for Kids