Vision insurance encourages people to take care of their vision and health. The Affordable Care Act requires all new (non-grandfathered) health insurance plans in the individual and small employer markets to include vision benefits for children age 18 and younger as an “essential health benefit.” This means if you’re getting coverage for someone 18 or younger on an individual or small group plan, vision coverage must be available as part of the plan or in a stand-alone plan. This benefit covers an annual eye exam and one pair of glasses or contact lenses for children. The law does not require plans to offer vision benefits for adults.
And as with dental benefits, you do not need to have vision coverage, even for children, to avoid penalties under the Affordable Care Act.
Still, vision coverage encourages individuals and families to get regular eye examinations. An estimated 11 million Americans have uncorrected vision problems, ranging from refractive errors (near- or far-sightedness) to sight-threatening diseases such as glaucoma or age-related macular degeneration. Regular eye examinations can also identify other health conditions, such as diabetes, that can affect the eyes even before the individual experiences noticeable symptoms.
Vision insurance generally covers the following basic services:
• Annual eye examinations, including dilation
• Eyeglass frames
• Eyeglass lenses
• Contact lenses
• LASIK and PRK vision correction at discounted rates.
For those who don’t have employer-provided medical benefits, many individual medical plans offer vision coverage as an add-on. You can also buy a separate individual vision insurance policy.