Shopping for glasses with vision insurance? You will probably see the term frame allowance. It is a simple idea once you know how it works.
Key takeaways
- A frame allowance is a set dollar amount your vision plan applies toward frames.
- If your frames cost more, you usually pay the difference.
- Benefits renew on a schedule, so check when yours resets.
- Plans differ, so ask your insurer and our team how yours applies.
What is a frame allowance?
HealthCare.gov defines vision coverage as a health benefit that at least partially covers vision care, like eye exams and glasses. Many vision plans express the frame part of that benefit as an allowance: a set amount the plan will put toward frames. Details vary by plan, and our team can help you read yours. See the HealthCare.gov definition of vision coverage.
How it usually works
- You choose frames you like.
- The plan applies its allowance to the frame price.
- If the price is higher than the allowance, you pay the difference.
- If it is lower, the unused amount usually does not carry over.
Whether the exam and lenses are covered separately depends on your plan. Ask before you shop.
Questions to ask your plan
- What is the frame allowance and does it apply to any frame?
- How often do benefits renew, every 12 months or every 24?
- Are there copays for lens extras, such as progressive lenses or coatings?
- Does the plan cover contact lenses instead of glasses, or in addition?
- Do I need to see an in-network provider?
Tips for making the most of it
- Check your renewal date so you do not lose a benefit.
- Bring your insurance card and plan name to the appointment.
- Ask your optician which frames fit the allowance.
- Remember you can use the allowance on prescription sunglasses if your plan permits; see our prescription sunglasses page.
Using your benefits at Reel Optics
We accept most major insurance plans, and coverage varies by plan. Read how to check with us on the vision insurance page, or follow our step-by-step guide to using your vision insurance benefits.
Frequently asked questions
Is a frame allowance the same as a discount?
No. An allowance is a set amount your plan pays toward frames, not a percentage discount, though some offers also include discounts. Check your plan documents.
Can I use my allowance on any frame?
Plans differ. Some limit allowances to certain brands or networks, so ask before you choose.
Visit Reel Optics in Old Bridge
If you would like help, our team in Old Bridge is here. You can book an eye exam or ask about vision insurance at Reel Optics Vision Center, 2553 County Rd 516, Old Bridge, NJ 08857. Appointments are recommended for eye exams, and walk-ins are welcome when you are shopping for glasses. 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.
