See Clearly: 5 Tips to Maximize Your Vision Benefits

See Clearly: 5 Tips to Maximize Your Vision Benefits

Apr 24 2019

If you’re one of the 75% of Americans who require vision correction, it’s important to take a look and make sure you’re getting the most out of your vision benefits.

About 3.4 million people in the U.S. go without vision benefits. And of those who do opt to add on vision coverage to their health plan, not all take the time to even use their vision benefits. In fact, a recent study showed while most people rate vision as their most important sense, only half got an eye exam in the past year.

Just like your annual medical check-up with a primary care provider or consistent dental exams, making time for eye health matters. According to the Center for Disease Control and Prevention (CDC), annual eye exams are important to find eye diseases like glaucoma or cataracts early and preserve your vision—no matter what your age. And with the average national cost of eyeglasses around $196 a pair, it’s important to know how to plan and budget so you can see clearly each year. If things are looking a little blurry in your world, it may be time to get your eyes checked. Whether you choose glasses or contacts, here are our top five tips for getting everything you need from your vision plan.

Know what your plan covers, and when.
Contact your vision benefit provider and create an online account if you don’t already have one. Review important details like co-pays, frame allowance and lens enhancement coverage per plan year. You can print a membership card from your vision provider if you’d like, although most eye retailers no longer require a physical card as long as they have your plan information.

Find an in-network eye doctor.
It’s important to work with an eye doctor and retailers that are covered in your plan. For example, Priority Health Medicare members receive vision benefits from EyeMed, a provider that partners with both independent providers and major retailers. Using an online search tool, you can find an in-network provider to take advantage of everything that’s covered in your plan—along with any potential discounts. Some out-of-network retail locations or websites may say they “accept” your vision insurance, only to offer a limited discount that’s not up to par with all of your in-network benefits.

Schedule a comprehensive eye exam every year.
This should be a check-up once every year of your vision and the overall health of your eyes. A great time for families is summer when schedules slow down a bit—and to prep for back-to-school. Everyone in the family needs eye exams: from babies all the way through teens. The U.S. Preventive Services Task Force  recommends vision screening for kids at least once between age 3 and 5 years to detect amblyopia or risk factors for the disease. Check with your child’s school system as many schools offer optional eye exams for all students during the school year. It’s important for kids to see clearly in school, as healthy vision can impact learning.

As for adults, the CDC recommends those at higher risk for glaucoma and should have a dilated eye exam every two years. This includes African Americans 40 years and older, all adults older than 60 and anyone with a family history of glaucoma.

If you’re experiencing any of the following eye problems, don’t wait for an appointment scheduled weeks out. Visit your eye doctor as soon as possible if you have:

  • Decreased vision
  • Draining or redness of the eye
  • Eye pain
  • Double vision
  • Floaters (tiny specks that appear to float before your eyes)
  • Circles (halos) around lights
  • Flashes of light

Shop smart for frames and lenses.
The key to shopping smart and keeping your budget in check is using in-network providers to get the most coverage for frames, contact lenses and any lens enhancements like anti-reflective coatings, progressives and light-reactive (photochromic) lenses. Keep an eye out for discounts and sales on specific frame brands. When it comes to online retailers and contact lens subscription services, use caution. It’s important to make sure your vision insurance is accepted, so you don’t get hit with any surprise costs—like having your reimbursement denied or being responsible for the full cost of any eyewear. Stay in-network, stay on budget.

Take advantage of any extras.
Many eye retailers—both in store and online—will offer what’s called a “second-pair” benefit. This could look something like 20% off on a second pair of glasses, including any lens enhancements, when you purchase from your in-network retailer within 12 months of your last eye exam. This is a great option for prescription sunglasses in addition to regular eyeglasses, for example. Perfect as you head into the summer months.

So remember: stay in-network and stay on budget. Plus, planning is key along with keeping an eye out for extra benefits and discounts. Follow these top five tips, and you’ll be seeing clearly all year long.

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