FAQ: Is Vision Insurance Provided in Every Health Plan?

Posted in Health Insurance , Vision Care

September 15th, 2009

The laws governing what health insurance must cover is mandated by the state in which the insurance policy is issued for a member. Combine the legal state variations along with the assortment of health care plans and it is truly impossible to use a broad description to apply to every type of health plan. Whether or not vision insurance is included in your health plan would be described in the terms of coverage for your specific policy.

Vision Care Basics

Vision insurance is a type of health insurance policy that would cover the expenses incurred by visiting ophthalmologists and optometrists. Typically, vision insurance would cover the costs of annual eye exams and even partial fees for corrective eye wear such as contact lenses or eyeglasses. Not all health plans cover eye care because not all health plans automatically include vision insurance.

When Health Insurance is Enough

Even without vision insurance, there may be times that your health care plan would indeed cover an eye care exam. For example, Diane was diagnosed with skin cancer, a stage 1A growth on her right forearm. In-office surgery was enough to remove themelanoma and cancerous cells directly from her arm. But additional tests were required to ensure that the cancer had not spread to any other part of her body, including her eyes. Diane was sent to an ophthalmologists for an eye examination and in this case, her health plan (a PPO in New York) covered 100% of the expense of the office visit.

Whether or not vision insurance is included in your health plan is determined by the unique policy you hold. It is up to you to review the packet provided to new members and determine if vision care would automatically be covered by the health care plan that you selected.