What’s the difference between vision benefits plans and discount vision plans?

Maintaining healthy eyesight is an essential aspect of overall health. Regular vision care like annual eye exams can catch and prevent eye disease early and significantly improve a person’s eye health. People who need corrective lenses, such as eyeglasses and contacts, use them to keep their vision strong and see the world more clearly.

Vision benefits plans and vision discount plans can make regular vision care significantly more affordable. These policies provide different levels of coverage, and knowing your options helps you make the most informed decision about your vision care. Learn more about vision benefits plans and discount vision plans in the guide below.

Vision Benefits Plans vs. Discount Vision Plans

According to the Centers for Disease Control and Prevention, around 11 million Americans require some sort of vision correction. People in the United States who wear eyeglasses or contacts pay an average of $231 for frames and $112 for single-vision lenses. Understandably, many people who need vision care want to minimize its cost.

Vision coverage reduces the out-of-pocket costs people pay for their regular vision care. Although all types of coverage require monthly or yearly payments, the overall cost can be significantly less than the price of the same level of care without vision coverage. Insurance and discount coverage are also typically less than the cost of treatments needed for vision loss. With regular eye exams, people can prevent many kinds of vision loss and the economic hardship and lower quality of life associated with them.

Vision benefits plans and discount vision plans are the two primary types of coverage people can purchase. Vision benefits plans are types of insurance, while discount vision plans provide discounts for the same products and services. Several differences between vision benefits plans and discount vision plans make each plan ideal for certain situations over others. Understanding these differences can help people make the best decision for their health.

Vision Benefits Plans Overview

A vision benefits plan is a true insurance policy. People with a vision benefits plan pay monthly premiums for vision coverage for annual eye exams, eyeglasses, contact lenses and other eye care needs. These policies may also require copays at the time of each visit, although the insurance company pays the rest of the balance.

Vision benefits plans provide different levels of coverage. For example, VSP and EyeMed are two of the most popular vision insurance companies for residents of California. VSP offers two vision insurance plans, one with a monthly premium of $15.16 per person and a $120 yearly eyewear allowance. The more comprehensive plan has a $19.24 monthly premium per person and covers up to $175 of eyewear costs. EyeMed provides three plans with a broader range of coverage options and premium costs.

Vision benefits plans are set up in one of two ways — as Health Maintenance Organization (HMO) plans or Preferred Provider Organization (PPO) plans. Most vision benefits plans are set up as a PPO. These two types of vision insurance have different requirements for patients, levels of freedom in choosing a provider and premium costs.

The Advantages of Vision Benefits Plans

The pros of vision benefit plans include:

• Reduced cost of care: Vision insurance lowers the overall cost of regular eye exams, prescription lenses and even some corrective eye surgeries like LASIK.
• Regular preventative services: Preventative care is critical for maintaining vision health. Regular comprehensive eye exams can catch eye issues like diabetic retinopathy, glaucoma and cataracts before they become serious. When people have insurance for yearly eye exams, they may be more likely to visit an eye doctor who can detect early signs of these diseases.

The Downside of Vision Benefits Plans

Vision plans come with one downside:

• Regular monthly premiums: Vision benefits plans always require a monthly premium. Some people who need vision care may not believe they will use the coverage often enough to justify the monthly expense. Premiums vary widely between plans, with the basic vision care plan from EyeMed only requiring a $5 monthly premium for one person.

Discount Vision Plans Overview

Discount vision plans aren’t true insurance policies. Instead, members pay an annual fee to receive a predetermined discount on qualifying services and products. Eye doctors and other providers within the plan’s network agree to offer discounted services because they’ve negotiated with the insurance company.

Discount vision plans typically offer discounts for the same types of services and products as vision benefits plans, including:

• Annual eye exams
• Eyeglasses and prescription lenses
• Contact lenses

Pros of Discount Vision Plans

If getting coverage from a discount vision plan sound appealing to you, consider the pros:

• Lower yearly cost: Most discount vision plans require yearly fees, as opposed to monthly, and don’t use premiums. The lack of premiums makes this policy more affordable than most vision benefits plans. A discount vision plan is the only way someone can get vision coverage without insurance.
• Lower fees for families: Many discount vision plans charge lower annual fees for families than for individuals.

Cons of Discount Vision Plans

Consider some of the cons of discount vision plans to determine whether they’re suitable for you:

• Lower level of coverage: A discount vision plan doesn’t provide the same level of coverage as a vision benefits plan. If a discount vision plan offers a 15% discount on an eye exam and a pair of frames, it could still be more expensive than the same services under a vision benefits plan. Vision benefits plans often provide a discount on the balance of each visit besides lowering the cost of care.
• Higher out-of-pocket cost: People with discount vision plans can expect to pay more in out-of-pocket costs for eye care services and products.
• Higher cost for out-of-network providers: Some discount vision plans allow members to receive out-of-network services. In these cases, people must pay in full at their visits and request reimbursement from the insurance company later.

Factors to Consider Before Buying Vision Benefits Plans vs. Discount Vision Plans

Each coverage type covers a different set of services at varying prices. When comparing vision benefits plans vs. discount vision plans, it’s essential to consider a few crucial factors:

1. You and Your Family’s Vision Care Needs

To determine which kind of vision coverage fits your family’s needs, look back to what you’ve spent on eye care in the last couple of years. If you and your family rarely need eyewear, coverage for an annual eye exam might be sufficient.

You might need more comprehensive coverage if you or your family use prescription eyeglasses or contacts. A vision benefits plan might better suit your needs if you routinely use eyewear.

2. Cost of Coverage

The annual cost of a vision benefits plan compared with a discount vision plan varies by insurance company and policy. However, discount vision plans typically cost less yearly unless you use the services frequently. Examine your options to determine the monthly and annual costs of each policy available to you.

3. Eyewear Allowance

Individual vision benefits plans vary, although most plans offer coverage up to a certain amount for eyewear like glasses frames and contact lenses. For instance, VSP and EyeMed eyewear allowances range from $120 to $200. If someone wants more expensive eyewear, they must pay the remaining balance. In contrast, discount vision plans only provide a discount on the total cost of eyewear.

Request a Quote for Vision Insurance

Obtaining vision insurance can help you and your family take the best care of your eyesight. Health for California provides an easy and fast online application process to simplify vision insurance for California residents. Our accurate quotes help you compare prices and plans to find the vision insurance that best suits your needs.

Our agents are ready to answer your questions and help you choose the right coverage. Contact Health for California and request a free quote for vision insurance today.