In today’s digital culture, concentration and attention are at a premium,1 which means we may only give seconds, if any, to the fine print. And when it comes to understanding your vision benefits, you may not be seeing all that’s offered.
At EyeMed, we know from our own research that many people, including our members, have much to learn about their vision benefits. In fact, many of those with vision insurance don’t understand terminology like co-pay and allowance—only 14 % of Americans understand many common insurance terms, according to a study in the Journal of Health Economics.2
To help bridge that gap of understanding, we’ve created a quick guide so you can easily swoop in and get the basics of your vision benefits.
What do I need to know?
While reading your vision benefit coverage material, you’ll come across several insurance industry terms. Don’t gloss over them if you’re unsure of what they mean.
How do I get vision benefits?
You may be eligible for vision benefits through your employer, which means you tend to pay lower prices since the employer is negotiating for a group of people. Others, however, opt to purchase plans independent from an employer for one or all members of the family.
What’s a co-pay?
A co-pay is the fixed amount of money you owe the doctor at the time of your visit. Co-pays vary based on the plan your employer has selected.
What’s an allowance?
An allowance is a set amount of money the plan covers toward the purchase of eyeglass frames or other items. Here’s a simple-to-follow example. If your plan includes a frame allowance for $100 and you select frames that cost $130, you’ll owe $30 for frames at the time of purchase.
How do I find out how much will I pay out-of-pocket?
What you pay depends on your specific benefits and what materials you choose. Understanding your co-pays and allowances as described above is the first place to start, but make sure to check out your full benefit summary or log on to your vision benefits account to see your full list of benefits. As an example, EyeMed members save an average of 72% with their benefits compared to those without vision coverage.
My friend at another company has the same vision carrier, but we don’t pay the same for exams or eyewear. Why not?
Each employer selects a vision plan for their workforce based on what they decide their employees need as well as how much the company and the average employee can afford.
When can I start using my benefits?
Usually, vision benefits last for 12 months and start either when you purchase your benefits directly or when the new benefit year starts through your employer.
How can I use my benefits?
Simple. The first step is to connect with an eye doctor near you and make an appointment. You’ll also want to pull up the details of your benefits before going so you know what to expect heading in.
How often can I use my benefits?
Vision plans vary, but generally, annual exams are a part of your benefit. Depending on your specific benefits, you might owe a small co-pay at your visit. Your vision plan will also specify coverage for vision correction – eyeglasses and contacts. And be sure to inquire into discounts on additional pairs of glasses, sun wear and even Lasik.
By now you probably know more about vision benefits than most Americans. Congratulations! By understanding the basics of how benefits work, you’re all set to get the most from your vision benefits.
“Get a Grip on your Information Overload with Infomagical,” http://www.npr.org/sections/alltechconsidered/2016/01/25/463232382/get-a-grip-on-your-information-overload-with-infomagical
Americans Don’t Understand Insurance, Let Alone Obamacare,” by Bruce Japsen Forbes, Aug. 10, 2013, http://www.forbes.com/sites/brucejapsen/2013/08/10/americans-dont-understand-insurance-let-alone-obamacare-study-shows/
“Buying glasses? When considering extras, keep your eyes open,” by Mary Jacobs, Dallas Morning News, May 6, 2013, http://www.dallasnews.com/lifestyles/health-and-fitness/health/20130506-buying-glasses-when-considering-extras-keep-your-eyes-open.ece