Many people are surprised to learn that vision insurance is separate from medical insurance. However, this dichotomy is not as clear-cut as initially meets the eye. For instance, there are a number of cases in which eye problems can be classified as a medical expense. Today, we’re going to break down some of the key differences between vision and medical insurance. Perhaps your employer offers vision as a supplemental benefit, but you aren’t sure if you’ll need it. If that’s the case, start here.
Can your eye exam be covered by medical insurance? Here are some of the basics of vision insurance.
Why are they separate?
You might be wondering: if eye health is part of my overall health, why aren’t vision and medical insurance grouped together? One reason behind this is that optometry was developed far more recently as a field than medicine. In fact, not too long ago, eyeglasses were constructed and sold by craftsmen rather than professional optometrists. Older generations had to pay out of pocket for these services, so you should feel thankful that such a thing as vision insurance exists today.
There is also the fact that medical care is, generally speaking, more important than dental or vision. Medical insurance covers procedures and medications that are crucial to your ability to live. Dental and vision are, more often than not, related to matters of comfort or cosmetics, rather than survival.
What does vision insurance cover?
Not all vision insurance plans are equal, but generally speaking they will cover the following:
- Annual eye exams
- Eyeglass frames/lenses
- Contact lenses
- LASIK surgery (this is less common, but many insurers will offer you a discounted rate on corrective surgeries)
When discussing voluntary benefits with your employer, be sure to ask about any limitations your vision coverage might have. For instance, many vision insurance plans do not cover non-prescription reading glasses, or prescription glasses if they are damaged or misplaced. As is to be expected, they may not cover any application fees or charges for missed appointments.
When is eye care considered medical?
Occasionally, eye exams can be covered by medical insurance. Generally speaking, this occurs when the issue at hand qualifies as medical rather than an issue with vision per se. For instance, if your concern with your eyes springs from diabetes or another medical problem, it would be considered a medical expense. If you sustained an injury to your eye that requires treatment or even surgery, you would require the services of an ophthalmologist—not an optometrist. Typically, these services would be covered by medical insurance as well.
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