If your health plan doesn't include vision coverage for adults, you can purchase a “standalone vision plan” to reduce your eye care expenses. The Marketplace does not offer separate vision plans, but you can contact an insurance agent or broker, or search for plans online. You can also contact your state's Department of Insurance. It's important to understand the services and products covered by the plan, such as eye exams, glasses, and contact lenses.
For instance, if you need medicines, your doctor will not be able to prescribe a prescription if you are using vision insurance. Additionally, some health insurance plans will cover a routine eye exam every two years, in addition to an eye exam for a medical eye problem. Even though your doctor found signs of glaucoma at the end of the exam, this visit would be covered by your “vision plan” because the main reason for the visit was to have your eyesight checked for new glasses. Since you're contributing your hard-earned money for your vision coverage, there's really no excuse to skip the annual eye exam or see your optometrist in case you experience any change in your vision.
Instead of copays, you'll pay a discounted rate (typically between 75 and 85%) of the total fee charged by your doctor. The type of eye exam you perform is determined by the reason for your visit or your primary complaint, as well as your diagnosis. Vision insurance covers ONLY routine eye exams for buying glasses or putting on and buying contact lenses. Cataract development monitoring, screening patients with diabetes Examination of patients who use medications with possible side effects on the eyes, such as steroid medications, arthritis medications, etc.
are not covered by vision insurance. For example, vision insurance will not cover vision loss, floaters, dry eyes, allergies, allergies, eye diseases, etc. infections, eye disease, or eye exams to check for complications from diabetes. You may have to go through some repetitive parts of the exam on those days because, by law, there are certain things that the ophthalmologist must document at each visit.
Understanding Your Coverage Insurance companies handle routine eye exams differently than medical policies.