Understanding Your Vision Plan

There is often confusion about vision plans and insurance,  Vision plans are not insurance but can be thought of as discount plans.  Insurance companies are charging premiums with the thought that they will be able to make money off  investments of your premiums and are calculating the risk of you having to file a claim.   Vision plans on the other hand know that the only people purchasing plans are those who intend to use the benefits.  So the only way  for them to be profitable is to charge more than they plan to pay.  Some of the biggest plans also own lens and frame manufacturers and require or incentivize offices to only use their product lines.  These companies often own retail outlets as well. Vision plans do help reduce the cost of your eyewear, however you should be aware that it is often at the expense of quality of the product.  It is important to note your optical shop needs to remain profitable to stay open, so it is incentivized to try and create the largest markup it can to offset the plans discount   This will lower the value proposition for your eyewear purchase especially for those without vision plans .  Often the best value is to use health savings and choose an optical shop that is not a provider for these plans.  As a final thought, anytime you add more parties into a transaction the greater the expense becomes.

Why do Vision
Benefits Look Like
a Good Deal?

  • You don’t pay the premium because the employer gives it to you free
  • The co-pay is low
  • You pick a frame that costs less than the frame allowance
  • You pick a lens that costs less than the lens allowance
  • You get a pair of glasses for free, or low cost

So Why are Vision
Benefits Not a
Good Deal?

  • You must use an In-Network office
  • Offices are ready for you: To make a profit, they do a few things:
    1. Inflate their prices
    2. Offer lower quality frames for vision benefits
    3. Use much lower quality lenses. (Lenses are much harder for patients to identify the quality)
    4. Upsell to more expensive add-ons
  • Some people forget to use their benefit, and lose it
  • Plans are complicated and are hard for anyone to understand

 

Here is a list of some of the most popular vision plans.  If your health insurance claims to have vision coverage, they most likely have sold that coverage to one of these vision plans.  This is to give the illusion that it is part of health insurance.