The Vision 'Insurance' Game

Vision insurance is a precarious entity.  On one hand, I see how a family can save money on the eye care they need, but too often lately I’m watching people overpay for basic vision plans.

I can make a blanket generalization: if you purchase new glasses every year or if you wear contact lenses, vision insurance may be for you.  For everyone else, a little more thought and calculation is required.

For instance, the other day I saw a patient who has been coming to our practice every year for nearly 20 years. My dream patient – she listens to our recommendations and takes her eye health seriously.

She told me she pays $8.00 per paycheck for her vision plan, which is $16.00 per month or $192.00 per year.  Every year she walks in and is so happy that her eye exam is fully covered, with no copay!  She continues with her over-the-counter reading glasses from CVS and is happy with this setup.

We charge $75 for an eye exam.

She pays $117 every year for “coverage” she doesn’t need.  And if she were to buy prescription reading glasses from us? We sell complete pairs of glasses for $80.  She’d still be over paying by $37.

I call it the “you pay double but I get half” phenomenon, and vision plans are laughing all the way to the bank.

And it amazes me everyday to hear current and former patients tell me they had to go to a discount optical for eye care because they “didn’t have any vision insurance.”

I try like crazy to educate everyone that we do take medical insurance for many eye complaints, which may cover their exam – thus eliminating the need for expensive and unnecessary duplicate coverage by a vision plan.

Now who should definitely purchase a vision plan?  A family of contact lens wearers.

Everyone else should review their options.

Vision plans know that utilization is only about 50%, meaning half the people who purchase a vision plan will never use it, despite paying their premium.

This is part of the trick where they get you to think it’s real insurance – where if something goes horribly wrong you will minimize your financial loss, and therefore a vision plan is worth having.  Vision plans actually don’t take on any risk, if the worst thing happens (OMG you need glasses), they already know the maximum they’re going to pay.

There is no chance of your vision plan being billed for MRIs or brain surgery.  At worst they give you a benefit on a frame that can only cost a few hundred dollars (around your yearly premiums).

So a vision plan works like a prepaid discount, one that you should only prepay  if you know you’re going to use it.

To give a modern day analogy: don’t buy a Groupon for a product you aren’t sure if you will ever use, but if you know you’re going to buy that product anyway, then of course prepay for that discount through Groupon. But no one runs around buying Groupons and stashing them away with no intention of using them, just in case.

Unfortunately, that’s what vision ‘insurance’ is to a lot of people.  It’s a conditioned check mark on a box during open enrollment for their company insurance coverage.  When they put $8 next to the $800 medical plan, it seems like a bargain.  But don’t be fooled by that small dollar amount, the cost is usually greater.