Vision coverage is an important part of health insurance. Just like you get annual health screenings for your body, your eyes also need routine exams.

According to the CDC, eye exams are important for both vision testing and eye health. Because your eyesight depends on it, vision insurance is something to consider.

How Does Vision Insurance Work?

Vision coverage can either be included as part of your health plan benefits package or it will need to be added separately as a stand-alone plan. Many employers offer it as part of a benefits package, but you may need to manually add it to your benefit elections.

Under the Affordable Care Act (ACA), pediatric vision care is covered under your health plan as it is classified as an Essential Health Benefit (EHB). This means that children are able to have routine eye exams, vision screenings, and glasses (or contacts) to improve their vision.

Some states may also include adult routine eye exams. It’s important to check with your insurance provider to see if you are covered.

What Does Vision Insurance Cover?

It depends on your insurance plan. Some vision plans will cover an exam, frames, and contact lenses. Some will only cover either glasses or contacts. Depending on the type of lenses you need for contacts or glasses, you may have to pay more.

Some plans will cover surgeries like LASIK, some may cover a portion, and some may not cover any of it. Complicated or major treatments and surgeries will most likely not be covered and will instead fall under your regular health insurance plan. It’s important to check with your insurer before getting care.

Does Medicare Cover Vision Screenings and Care?

Medicare (Parts A and B) does not offer coverage for routine eye exams. However, some Medicare Advantage Plans (Part C) include vision coverage as an added benefit, but this is dependent on the specific plan. There are some exceptions to this.

• If you are on a Medicare Part B plan and have diabetes, you will have coverage for eye exams related to diabetic retinopathy annually.
• If you are on a Medicare Part B plan and have a high risk of developing glaucoma, you are eligible for glaucoma tests every year. To be considered high risk, you must either have diabetes, a family history of glaucoma, be African American and 50 years of age or older, or be Hispanic and 65 years of age or older.
• If you are on a Medicare Part B plan and have age-related macular degeneration, you may have coverage for specific diagnostic exams and treatments.

Learn more about Medicare’s vision coverage here.

Frequently Asked Questions About Vision Insurance

Does health insurance cover vision?

Not usually. Some employers will offer it as a package or an add-on you can choose to pay for, but eye exams and services are often not covered under health insurance plans.

Does vision insurance cover contacts?

Sometimes – it depends on your plan. Many vision insurance plans will cover a certain dollar amount toward contact lenses each year. If your contacts cost more than the allotted amount, you will be responsible for the balance.

Some plans will cover the cost of contacts or glasses but not both. Check with your insurer before making a purchase.

Does vision insurance cover glasses?

Sometimes. Like contact lenses, vision insurance will typically cover at least some portion of the cost of prescription glasses.

How much is vision insurance?

It varies. If you have an employer-sponsored plan, it may be less than purchasing a policy on your own.

The size of your family, your age and other factors can increase or decrease your monthly premium.

Can you add vision insurance at any time?

Typically no. When you sign up for a health insurance plan during Open Enrollment, you will also have the chance to purchase a vision insurance plan. For Medicare Advantage plans, you may receive with your plan or have the chance to purchase a vision plan at time of enrollment.

If you have a Qualifying Life Event that allows you to buy a health insurance policy outside of the Open Enrollment window, you may be able to sign up for a vision insurance plan at that time.

No matter what health plan you’re on or insurer you have, it is wise to contact your insurer directly with any health-related coverage questions. Your eye health is just as important as your physical health. Start by routinely seeing your eye doctor and getting the exams you need to keep your vision clear.