Midwest Vision Explains: Insurance and Your Eye Care

Insurance can be confusing — we understand. On any given day, we get more questions from patients about insurance than anything else. At Midwest Vision Centers, we want to make eye care accessible to everyone, and part of that is helping you concern yourself more with the health of your eyes than you do about paying for your care.

We accept a variety of different insurance policies and will work to ensure that you get the most out of your benefits. Here’s some information that we hope will answer any questions you might have about your vision insurance.

First, What is Vision Insurance?

Vision insurance can help reduce the cost of basic eye care services and eyewear in exchange for paying an annual or monthly premium. The larger the premium you pay, the less you will pay out of pocket for eye care and eyewear.

Most people with vision benefits get it through their (or a family member’s) employer. If this route isn’t available, you may be able to find standalone insurance coverage for a small monthly payment, or add it on by purchasing a “rider” for vision through your dental or basic health plan.

What Can Vision Insurance Cover?

Often, vision insurance will cover at least a portion of the costs of the following:

  • Eye exams
  • Glasses lenses and frames
  • Contact lenses
  • Certain lens enhancements, such as scratch-resistant coatings

Generally, vision benefits happen in two ways. The first is through something called a copayment, or “copay” for short. This is more common for eye exams and other standard eye doctor’s visits. In this case, you might be asked to pay a flat sum of, say, $20 for your appointment, which would cover all approved procedures or screenings that take place.

Vision insurance plans may also give you a preset sum of money that can be spent on certain eye care services and eyewear, such as exams and glasses, each year. If your plan doesn’t have a deductible — most vision insurances don’t — then you can spend your benefits without having to pay anything out of pocket.

What Can Vision Insurance Cover?

Unfortunately, there are a few services that vision insurance doesn’t cover. Mainly, this is the case for elective procedures, including laser vision correction surgeries like LASIK and PRK. Insurances don’t view laser vision correction as necessary and won’t cover the cost of the procedure outside of a few rare exceptions. Some vision insurers let you purchase add-ons to help defray the cost of some of these procedures, so if you’re considering LASIK or a similar procedure, this may be something to look into.

Many vision insurances also don’t cover medically necessary eye care. Treatment for eye diseases like cataracts, glaucoma, and age-related macular degeneration (AMD), are instead covered by medical insurance plans. With this in mind, preventative services are typically part of your vision benefits, and evaluations for eye diseases like these are performed during every comprehensive eye exam at Midwest Vision.

What Can Vision Insurance Cover?

HSA and FSA Insurance

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are tax-free accounts that can be used for “qualified medical expenses”, including eye care. Both have limits to the total amount you can put in them, but there are a few key differences:

HSA

HSAs are available to those with high-deductible health plans, and contributions to your account are tax-deductible. You can change how often you contribute to the account, and all unused balances will roll over at the end of the year.

FSA

FSAs are only available when offered by an employer. Contributions to this account are made pretax and distributions from the account are untaxed. However, FSA funds need to be spent before the end of the year or they are forfeited.

What Can Vision Insurance Cover?

How to Use Vision Insurance at Midwest Vision

At Midwest Vision, we accept many major eyewear insurance providers, including:

  • MMSI
  • EyeMed
  • OptumHealth
  • UnitedHealthcare
  • Sanford Health
  • UCare
  • Medica
  • TRICARE
  • Spectera
  • PreferredOne
  • VSP
  • Medicare
  • Aetna
  • HealthPartners

These are only a few of the many insurances that we accept, and the list changes every year, so before scheduling an appointment, make sure your insurance is accepted here. At Midwest Vision, we want to help you get the most out of your benefits and will work with both you and your insurance to make sure that happens.

If you have any questions or need guidance, our staff is here to help.

Contact the Midwest Vision location nearest you to learn more about how to use your insurance for your eye care and to schedule your next appointment.