How to Use Vision Insurance – All About Vision

As soon as you buy or enroll in a vision insurance plan, get a copy of your plan’s brochure or find out how to access it online. Please review the booklet carefully to determine what your benefits include, what costs are involved, and who is on your list of network providers.

Also, look for answers to the following questions. (For definitions of unfamiliar terms, see our glossary of vision insurance terms.)

Reading: How to use vision insurance

general questions:

  • What services am I entitled to under my vision plan?

  • who is on the list of network providers?

  • How do I make an appointment with an ophthalmologist?

  • What quality control mechanisms exist?

  • what is the process for resolving complaints?

    Questions about vision benefit packages:

    • Do I need an ID? card? if so, how can i get one?

    • How much deductible do I have to pay before the insurance company starts paying its share of costs?

    • how much is my copay for each service?

    • Are there limits to what the plan will pay for any of the services?

      See also: Virginia Private Health Insurance Plan Ratings – NCQA

      questions about vision discount plans:

      • How much deductible do I have to pay before discounts are applied?

      • what discounted rate can I expect to pay out of pocket for each service?

      • To whom should I pay the discounted amounts? Should I send the payment to the vision insurance company, the eye care provider, or both?

      • How do I pay for services? Do I use a prepaid discount card, prepaid coupons, cash, check, or credit card?

        questions about out-of-network providers:

        • Does the plan allow out-of-network providers?

        • Do out-of-network providers have to be approved by the vision insurance company for me to receive reimbursement?

        • How do I request reimbursement for out-of-network services?

        • What amounts can I expect to be reimbursed for each service?

          use your vision insurance for an eye exam

          Once you understand your benefits and know which providers you can use, you’re ready to make an appointment for an eye exam.

          need a doctor? click here to find an ophthalmologist near you.

          When you make your appointment, be prepared to provide the optometrist or ophthalmologist with the name of your vision insurance company, the name of the plan under which you are covered, and your ID. number.

          See also: What is a Life Insurance Dividend? • The Insurance Pro Blog

          This is because your eye doctor may need to obtain prior authorization from your vision insurance company before performing your exam.

          At the time of your appointment, you will be asked to show your vision insurance ID. card or provide some other proof of vision insurance coverage. Depending on your vision plan, you may also be required to pay a deductible and/or copay or discounted prices for the services you receive.

          If you need prescription glasses, your optometrist or ophthalmologist can also help you choose glasses or fit contacts if these services are available on site.

          If you select an out-of-network provider, you can expect to pay full retail price for the services you want at the time of service. Generally, you must submit a request for reimbursement and an itemized copy of all your receipts to your vision insurance company to receive reimbursement.

          How do I know when I shouldn’t use my vision insurance benefits?

          You can choose not to use your vision insurance when you are restricted to using network providers only, or when…

          • The optometrist or ophthalmologist you feel comfortable using is not on your vision plan’s preferred provider list.

          • The nearest network provider is farther than you are willing to travel.

          • It takes too long or it’s impossible to get a convenient appointment with a network provider.

          • The selection of eyeglass frames offered by your preferred supplier is not what you want. Eyeglass frames should fit the shape of your face and should match the fashion statement you want to make.

          • when the glasses you prefer are not covered by the vision plan.

          • when you can get cheaper service by going outside the provider network. For example, some online eyeglass and contact lens services can be obtained at very low cost.

            You may have other considerations when planning to have lasik or prk refractive surgery. Because this is an elective surgical procedure for vision correction, you should choose the most qualified and experienced eye surgeon available. this should be your priority over shopping for the lowest cost or accepting only a provider approved by your vision plan.

            page published on Wednesday, February 27, 2019

            page updated on Wednesday, March 16, 2022

            See also: Overview of Policies

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