What Eye Care Insurance Covers

• Most of the policies provide discounts for annual eye exams and either contact lenses or eyeglasses. Most eye care insurance will provide discounts on both single vision lenses and multivision lenses with lines as well as a limited number of frames, as well. There are some carriers that will only provide coverage if you choose glass lenses.
  
  The exam can either be conducted by an ophthalmologist who is also an M.D. or by an optometrist. Either way, the discount will be provided by most insurers.
  With respect to the exams, many life-threatening illnesses, such as diabetes, high blood pressure and brain tumors, can be detected during a regular eye exam.
  
  

Who Provides Coverage?

• The majority of eye care insurance companies are preferred provider organizations (PPO), which contracts with optometrists and ophthalmologists to render services. If you choose an eye care professional who is out of that network, you must first pay for the service, then seek reimbursement from the insurance company. Generally, you will save money by going to someone within the network. Finally, you will pay a small co-pay for most services rendered by professionals in the network.
  
  

How Do I Use It?

• The services provided by eye care insurance companies vary widely; so after you have enrolled, be sure to read the information that is provided for your plan. This information includes the services that are covered, the list of professionals in your network and how you should go about making your first appointment. It answers questions like whether you need an identification card at the professional's office and the amount of any deductibles you must pay with each service before the discount is applied. Finally, if you choose to go to a professional who's out of the network, the information will include the proper way to make a claim and how much reimbursement you can expect.
  
  

Medicare Eye Care Coverage

• You probably should have eye care coverage in addition to Medicare; however, Medicare does pay for glaucoma tests each year if you have diabetes or are in a family with a history of glaucoma, an African-American or a Hispanic. In addition, Medicare will cover basic cataract surgery and eyeglasses resulting from cataract surgery. Finally, Medicare will pay for the cost of removal of the eye and replacing it.
  
  

Evaluate Plans

• If you are not offered eye care coverage where you work, you will need to evaluate available plans. Start by estimating your eye care needs for your family. Then look through the plans that provide those services, with emphasis on those that will save you the most money. If you or your family are interested in having refractive surgery such as LASIK, which is quite expensive, some plans include it along with routine eye examinations, eyeglasses and contact lenses.