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- Vision Insurance
- VSP Contributor, 26 Jun 2024
How Is Vision Insurance Different from a Vision Discount Plan?
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When it comes to caring for your vision and eyes, understanding the plan options available — and how to manage the costs — can make a big difference. Having some kind of vision coverage can help with your eye care costs. Two common vision plan options are vision insurance and vision discount plans.
While both types of plans offer financial benefits, their coverage and costs are structured differently. Each takes a different approach to coverage for eye exams, eyewear, lens enhancements, and surgical procedures like LASIK eye surgery. Let’s get to know each type of plan, and then look at how each one typically helps with the costs of specific vision care services.
Vision discount plans are not the same thing as vision insurance. Vision discount plans provide a discount on vision services and products in exchange for a membership fee. You pay the vision discount provider out of pocket at a discounted rate when you receive eye care and vision services. There is no claim process or reimbursement; instead, the discount is applied immediately at the point of purchase. These plans are generally cheaper than a vision insurance plan and can be used as often as needed without any annual limits.
Vision insurance is like health insurance—you pay a premium and, in return, you have access to vision benefits that can cover a large part of the cost for eye care and eyewear. These benefits typically include comprehensive eye exams, glasses, and contact lenses. Vision insurance may also offer discounts on procedures like LASIK eye surgery. Typically, vision insurance plans have annual benefits limits and may include deductibles, co-pays, or coinsurance.
Next, let’s look at how vision discount plans and vision insurance approach coverage for specific vision health services.
An eye exam is a full-service evaluation of your visual health conducted by an optometrist or ophthalmologist. An eye exam goes beyond just checking if you need glasses. An eye exam assesses the overall health of your eyes and can detect early signs of serious conditions like cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Both types of plans usually cover routine eye exams, but they do so differently.
Vision discount plans might offer a fixed discount on the cost of eye exams at participating providers. For example, a plan might offer 20% savings off the cost of an exam. While this doesn't eliminate the cost, it does reduce out-of-pocket expenses every time you visit an eye care professional.
On the other hand, vision insurance plans typically cover the cost of an eye exam after a small copay, often once per year. Plan coverage can include tests for eye health and vision acuity, and it may partially cover the cost of contact lens fittings and evaluations.
When it comes to eyewear such as eyeglasses and contact lenses, including lens enhancements like anti-reflective coatings or progressive lenses, the available benefits between vision discount plans and vision insurance can differ significantly.
Vision discount plans usually provide a percentage discount on the purchase of eyeglasses and contacts. Discounts can be substantial, such as 25% off frames and lenses or 10%–15% off contact lenses. However, unlike a vision insurance plan, there is no cap to how much you can spend—the discount simply reduces the out-of-pocket cost.
Vision insurance plans often cover glasses and contact lenses up to a certain dollar amount per year after a deductible is met or for a co-pay. This coverage typically includes frames, lenses, and basic lens treatments. Some plans may also allow a set dollar amount toward lens upgrades. These upgrades can include:
Laser eye surgery, such as LASIK, is an area where the difference between vision insurance and discount plans becomes very noticeable.
Vision discount plans typically provide a percentage off the retail price of laser surgery at participating eye surgery centers. The discount can be a fixed percentage off the total cost or a set discounted fee.
Some vision insurance plans offer a benefit for surgical eye procedures, including LASIK. A vision insurance plan might not fully cover the cost but can offer a significant discount or a negotiated rate with certain providers that can lower the cost more than a vision discount plan.
Choosing between vision insurance and a vision discount plan depends largely on your specific eye care needs and financial situation. If you require regular eye exams, wear glasses or contacts, and are considering eye surgery in the future, you may want to choose full-service vision insurance coverage.
However, if you are primarily concerned with managing costs and can pay out of pocket for services at the time of care, a vision discount plan could offer the flexibility and cost savings you need.
Looking at your available plan options is a great way to start. VSP®, the largest vision insurer in the U.S., offers a way for your to find the right vision insurance plan for you that connects you to VSP's sizable eye doctor network.
Understanding the differences between vision discount plans and vision insurance is crucial to making an informed decision that aligns with your vision and eye health needs and budget. Whether you choose vision insurance or a discount plan, the most important thing is ensuring you have access to the necessary eye care services to maintain or improve your vision and overall eye health.
Information received through VSP Individual Vision Plan’s social media channels is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Dr. Valerie Sheety-Pilon is Vice President of Clinical and Medical Affairs at VSP Vison Care where she helps drive strategic initiatives aimed at raising awareness about vision, eye health and its connection to overall wellness, while providing insight into medical advancements that seek to benefit patient care. She also provides oversight of VSP programs to address gaps in care for some of the most high-risk populations, including those living with diabetes.
With more than two decades of experience as a Doctor of Optometry, Dr. Sheety-Pilon has dedicated much of her time to clinical research across numerous ophthalmic subspecialties and has an established history of helping patients through novel therapeutic agents and clinical adoption of transformative technology in the areas of digital health, pharmaceuticals, and medical devices.
Prior to joining VSP Vision in 2019, Dr. Sheety-Pilon served as Adjunct Clinical Professor at Illinois College of Optometry, held various executive positions within the eye health industry, and has extensive experience managing and practicing within an ophthalmology and optometry practice.
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