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Options Can Make Vision Plans Affordable

Options Can Make Vision Plans Affordable

Posted: June 14, 2016


While nearly all Wisconsin public employers provide health insurance to their employees, vision insurance is often not included. And lack of vision insurance often impedes eye care, as Americans who have vision insurance are twice as likely to have an eye exam as those who don't.

While eye care is recognized as an "essential benefit" under the Affordable Care Act, most groups are not required to provide such care. Some employers choose to include an adult vision exam as part of their health insurance plan, but others don't. Fewer employers may choose to exclude coverage for eye care from their health plan since premiums for vision coverage are not subject to the "Cadillac Tax," which is looming in 2018.

Vision exams and general health

Glaucoma, macular degeneration, and cataracts are the three leading causes of vision loss in the U.S. Also, regular eye care is a vital component of preventive medicine. According to the American Optometric Association, several chronic health conditions can beidentified during a routine eye exam, including:

  • Hypertension;
  • Inflammatory conditions;
  • Tumors; and
  • Undiagnosed strokes.

With constrained budgets, many employers believe they cannot afford to pay for vision insurance. But many fully insured vision plans are also offered as voluntary plans in which employees pay the premium. A voluntary benefit can still reduce the employees' out-of-pocket costs by steering them to network providers and suppliers.

Some employers will choose to pay a small portion of the premium (20% for example), as even a small benefit can lead to patients being more proactive with their care.

Flexible features

The flexibility of vision plans allows employers to meet the objective of offering solid benefits while still controlling costs.

Many vision plans will have a network for the best benefits, but still pay a reduced benefit for services outside the network. This gives patients more choice, especially if they would like to stay with a particular doctor, clinic, or optical center.

Another feature to look for is a plan that doesn't restrict where members can get their glasses, frames and contacts. This allows the member and their optician to find the best match for particular prescriptions.


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