Vision insurance can lower the cost of an eye exam and new glasses or contacts, but the benefits are not always obvious. A few minutes of checking before your visit can save you surprises at the counter.
Key takeaways
- Vision plans and medical insurance are different, and each covers different things.
- Check exam coverage, frame allowance, lens coverage, contacts and renewal timing.
- HealthCare.gov says all Marketplace plans include vision coverage for children, and only some include it for adults.
- Medicare.gov says Original Medicare does not cover routine eye exams for glasses or contacts.
Vision insurance and medical insurance are different
HealthCare.gov defines vision coverage as a benefit that at least partially covers vision care, like eye exams and glasses. A vision plan typically helps with routine care. Your regular medical insurance may apply when an eye problem is a medical issue, and it often follows different rules. See our vision insurance page for more.
What to look up on your plan
- Exam coverage. Is the eye exam covered, and is there a copay?
- Frame allowance. Many plans pay up to a set amount toward frames, and you pay the difference if you choose a frame that costs more.
- Lens coverage. Basic lenses are often covered, while extras such as progressive lenses, special coatings or light-adjusting lenses may cost extra.
- Contact lenses. Plans often treat contacts differently from glasses, and some give you an allowance for one or the other, not both.
- How often. Benefits usually renew on a schedule, so check when yours resets.
Marketplace and Medicare
HealthCare.gov says all plans in the Health Insurance Marketplace include vision coverage for children, and only some include it for adults. Medicare.gov says that Medicare does not cover routine eye exams for glasses or contacts, though some Medicare Advantage plans offer vision benefits.
Steps to get ready
- Find your insurance card and note the plan name and member ID.
- Call the number on the card or check your plan’s website for your benefits.
- Call us at 732-707-3877 or send a message with your plan name, and we will tell you how it applies before your visit.
- Bring your card to your appointment.
Good questions to ask
- Are the exam and the glasses covered separately?
- Is there a copay for the exam, or for lens extras?
- Does the allowance apply to any frame or only certain ones?
- When do my benefits renew?
Using your benefits at Reel Optics
We accept most major insurance plans, and coverage varies by plan, so please check with us. When you are ready, schedule an eye exam with Dr. Kenneth D. Manning, O.D., and take a look at our frame showroom.
Frequently asked questions
Do you accept my insurance?
We accept most major insurance plans and coverage varies by plan. Send us your plan name and we will confirm before your visit.
Visit Reel Optics in Old Bridge
Questions about how your plan applies? Our team at Reel Optics Vision Center, 2553 County Rd 516, Old Bridge, NJ 08857, can help. See hours and directions on our Old Bridge page, or send us a message.
Related reading
Sources and further reading
This article is general information, not medical advice and not a diagnosis. For questions about your own eyes, talk with your eye doctor.
