Author Topic: Is it cheaper to go without vision insurance?  (Read 7412 times)

gbbi_977

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Is it cheaper to go without vision insurance?
« on: June 22, 2016, 07:12:29 AM »
Hello,

In a few threads here and there, I've seen off-hand comments that vision insurance is often not the best way to get good-value glasses/contacts.

DH just started wearing glasses last year and we did what we assumed we were meant to do, and got vision insurance for him the last two years. I think he pays $14/month. He gets one eye exam a year with a $35 co-pay if it's for lenses. Last year (year 1) his glasses were covered, other than the anti-glare treatment (which we skipped, and he now regrets). This year (year 2) he paid about $200 and got a 6 month supply of contacts (he only needs them in one eye - got the ones that last for 2 weeks) and then the optometrist had a deal where that gave him half off a pair of prescription sunglasses.

Looking to next year, I think his prescription is changing but fairly slowly (it was slightly different this year to last year). He loves the frames on both his eyeglasses and his sunglasses. He's enjoying having the option to wear contact lenses for sport/biking. So I think moving forward the expected needs are (i) new lenses for the existing frames x 2 [at some point - depending on when prescription changes? I don't wear glasses, sorry if I'm jumbling all this] and (ii) more contacts.

Does anyone know of a good website for cost comparing the different out-of-pocket/no insurance options? Would you agree with the posters I've seen who've said vision insurance is usually a rip-off, or do you think it can sometimes be worth it? Basically we don't know anything about it and would love your advice.

ltt

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Re: Is it cheaper to go without vision insurance?
« Reply #1 on: June 22, 2016, 07:30:54 AM »
We have a vision program through my husband's employer.  I don't think I'd carry it if it were for one person.  Probably best to pay out-of-pocket.  However, 6 of us in our family wear glasses/contacts, so it works for us.

Miss Piggy

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Re: Is it cheaper to go without vision insurance?
« Reply #2 on: June 22, 2016, 07:39:22 AM »
I've never really felt that my vision insurance helped me all that much. I buy glasses every couple of years. Maybe contact lens wearers get more of their money's worth from their insurance???

Dezrah

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Re: Is it cheaper to go without vision insurance?
« Reply #3 on: June 22, 2016, 07:39:35 AM »
I've never been able to make the math work out in favor of vision insurance.  Even when the numbers favored buying the plan, the margins were so close that the hassle factor of dealing with insurance made it not worthwhile.  My current employer provides complimentary vision and it's still a PITA.

I don't think it's because insurers are scammers or trying to "rip you off", it's just that the services are very predictable and products are basically commodities. There's little to no room for insurers or customers to negotiate.  It doesn't help that a large factor in pricing for frames comes from style, something that insurers are simply not going to pay for. 

I'm guessing the only way to come out appreciably ahead with insurance is if you have a NEED for very expensively priced contacts AND you're prohibited from using glasses for some reason.  I've seen plans worded such that they can deny claims for contacts if glasses were a viable cheaper alternative.

If you want to cost compare, call your optometrist and ask their pricing, go to 1-800 Contacts.com (or similar) to get pricing on contacts (everyone sells for about the same, some just offer better shipping occasionally), though I'm not sure where to go for lenses.

Keep in mind, insurers will usually chip in for contacts OR glasses, but not both.


We have a vision program through my husband's employer.  I don't think I'd carry it if it were for one person.  Probably best to pay out-of-pocket.  However, 6 of us in our family wear glasses/contacts, so it works for us.

This is a good point.  Everything I've said was based on my experience as a couple, no additional family members.

mskyle

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Re: Is it cheaper to go without vision insurance?
« Reply #4 on: June 22, 2016, 07:48:27 AM »
If you're paying the full cost of the vision insurance yourself, it's almost definitely cheaper to go without, unless you absolutely MUST buy your glasses from a traditional high-cost optician. And even then, it might be cheaper to go without.

Call around and find out how much an eye exam costs without insurance. I think for me it's something like $100-150 (including the exam for contacts). I buy my glasses for $100-150 from Warby Parker and they last me two years or more (my prescription doesn't change much). I have, in the past, bought glasses online for as little as $30, and they were fine (and they had anti-glare coating). I buy my contacts online as well, in bulk for a small discount (I wear dailies because I only use them occasionally).

So for me, every two years I would pay maybe $150 (exam) + 100 (glasses), not including contacts (which cost pretty close to the same everywhere, with or without insurance). Even if I spent $200 on glasses, I would still be below what you would be paying for the exam copay + premiums with your insurance.

The reason vision insurance is such a blah deal is because the costs are very predictable and only people who need it buy it. Full health insurance costs are highly variable and potentially catastrophic, so lots of people buy health insurance and mostly don't use it. Vision insurance ends up being more like a payment plan than true insurance. Also, a lot of the vision insurance plans are owned by the same companies that sell the glasses/contacts!

Oh and finally: I would say get new glasses (even if they're nearly the same!) rather than getting new lenses for existing frames. It's only a little more expensive and then you have spare glasses and you don't have to give up your glasses and worry that they're going to break them (they broke my favorite frames).
« Last Edit: June 22, 2016, 07:50:27 AM by mskyle »

Spork

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Re: Is it cheaper to go without vision insurance?
« Reply #5 on: June 22, 2016, 08:15:03 AM »
I've done the math on my own vision insurance and ... it was cheaper for me to go without.  Your situation may vary depending on how much it may be subsidized by employer/etc.

In my case:
* There were only 5 "in-network" doctors in town -- and they were kind of skeezy.  It was the docs advertising on the tv/radio all day.  And if you went in the office there were also all sorts of offers where the optometrist was selling various shady supplements and "lose weight fast" programs.  It just felt... wrong.  A few friends that went to one of them complained the prescriptions were slightly wrong once they got their glasses.
* They paid some for out of network... but not much. 

Choices

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Re: Is it cheaper to go without vision insurance?
« Reply #6 on: June 22, 2016, 08:52:01 AM »
We found that our insurance only covered the more expensive doctors/clinics, so the premiums plus copays were about the same as going to Costco and paying out of pocket.
Plus, for the years we don't need to buy new glasses or contacts, we save the money we would have spent on premiums.
You can also try zennioptical.com for glasses.

Gimesalot

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Re: Is it cheaper to go without vision insurance?
« Reply #7 on: June 22, 2016, 08:52:32 AM »
You should check your health insurance plan, most will cover one yearly eye exam.  I use my health insurance for the eye exam and I buy glasses on-line for about $15 to $20 a pair.  This year, I am thinking about using my health insurance eye exam for a contacts evaluation and purchasing a pair or two online for when I can't wear glasses.

Lake161

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Re: Is it cheaper to go without vision insurance?
« Reply #8 on: June 22, 2016, 11:37:35 AM »
Since we are FIRE, we would have to buy our own insurance.

For my husband, who wears progressive glasses and doesn't change his prescription much year to year, going to a discount clinic and paying out of pocket makes sense.

For me, because I wear very expensive $200-$300 per lense rigid gas permeable lenses that are medically necessary, I'm not so sure. Even though most plans don't cover these lenses or the necessary exam in full, it may be that the better rates they get on the exam and the discount on the lenses will make it worthwhile. I have a few more calls to make to check out the prices with and without insurance.

Anyone else have experience with RGPs and insurance?

catccc

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Re: Is it cheaper to go without vision insurance?
« Reply #9 on: June 22, 2016, 11:45:05 AM »
It really depends on your needs and insurance cost.  My employer's vision insurance is so low that it's a no brainer for my family of 4. $36 for the whole year.

SimplyMarvie

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Re: Is it cheaper to go without vision insurance?
« Reply #10 on: June 22, 2016, 12:39:32 PM »
We got it this year, after a huge $200+ exam bill for my middle kid when he needed glasses before they'd let him into school. That was probably a failure of mine, considering I could have shopped around more but was under a lot of stress and didn't plan very well. *sigh* Mall Opticians are the spawn of satan, live and learn?

We do have four out of five people wearing glasses in our family, so we could probably make out better with vision insurance if we had 4x $150 exams and 4 pairs of full-price glasses. Which we will try to do this year, since we're paying for the insurance. But it costs something like $45 per month, so unless we ALL get expensive exams and expensive lenses every year, it's not worth it. I'm planning on getting LASIK this year or the next, so at that point it likely wouldn't be worth it anymore.

On the other hand, I haven't found a good online source for cheap glasses for kids -- and the one we did find sent us the wrong prescription for my son's glasses, so I'm not going back there. If you've got a lot of kids, and zenni, or the other online places aren't an option, it could be a reasonable purchase.

Spork

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Re: Is it cheaper to go without vision insurance?
« Reply #11 on: June 22, 2016, 12:44:45 PM »
Since we are FIRE, we would have to buy our own insurance.

For my husband, who wears progressive glasses and doesn't change his prescription much year to year, going to a discount clinic and paying out of pocket makes sense.

For me, because I wear very expensive $200-$300 per lense rigid gas permeable lenses that are medically necessary, I'm not so sure. Even though most plans don't cover these lenses or the necessary exam in full, it may be that the better rates they get on the exam and the discount on the lenses will make it worthwhile. I have a few more calls to make to check out the prices with and without insurance.

Anyone else have experience with RGPs and insurance?

I used to wear them... finally stopped due to progressively dry eyes.  My vision insurance would pay $100 towards glasses or contacts (but not both).  I didn't like the docs they covered, so they payed out of network... and paid a little less.  I generally gamed it so I went to the doc late in the year and got contacts in December, then got glasses the following January.

Dictionary Time

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Re: Is it cheaper to go without vision insurance?
« Reply #12 on: June 22, 2016, 01:00:43 PM »
On the other hand, I haven't found a good online source for cheap glasses for kids -- and the one we did find sent us the wrong prescription for my son's glasses, so I'm not going back there. If you've got a lot of kids, and zenni, or the other online places aren't an option, it could be a reasonable purchase.

WalMart is a good place for kids' glasses. An exam is around $50 and the glasses start at $30 as far as I recall. We've always gotten great service there, which you may not expect from Wally World. Right before my mom's funeral, one kid broke their glasses and they really went above and beyond to find a store in the are with those frames in stock so we could switch the lenses out.

Even with 5 of us in glasses, it still doesn't work for us. It comes close, but not really worth the hassle.

sis

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Re: Is it cheaper to go without vision insurance?
« Reply #13 on: June 22, 2016, 02:03:32 PM »
We got it this year, after a huge $200+ exam bill for my middle kid when he needed glasses before they'd let him into school. That was probably a failure of mine, considering I could have shopped around more but was under a lot of stress and didn't plan very well. *sigh* Mall Opticians are the spawn of satan, live and learn?

We do have four out of five people wearing glasses in our family, so we could probably make out better with vision insurance if we had 4x $150 exams and 4 pairs of full-price glasses. Which we will try to do this year, since we're paying for the insurance. But it costs something like $45 per month, so unless we ALL get expensive exams and expensive lenses every year, it's not worth it. I'm planning on getting LASIK this year or the next, so at that point it likely wouldn't be worth it anymore.

On the other hand, I haven't found a good online source for cheap glasses for kids -- and the one we did find sent us the wrong prescription for my son's glasses, so I'm not going back there. If you've got a lot of kids, and zenni, or the other online places aren't an option, it could be a reasonable purchase.

You can usually get a LASIK consult for free.  Go see if you qualify before making any insurance decisions.  I qualified for (and got) LASIK but DH did not.

MTA: Your vision insurance may also give you a discount on LASIK which is definitely worth investigating.

Kax

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Re: Is it cheaper to go without vision insurance?
« Reply #14 on: June 23, 2016, 09:05:06 AM »
My recommendation is just to search for the best price you can pay for your vision and then make the math and decide if such insurance works for you personally or not.

For example I made some research and found solution how to cut my expenses on my contact lenses by 50%:

I use Walmart for an eye exam for contacts ($100 instead of standard $200) then get my prescription and buy contacts online - it's much cheaper.  To compare offers from online stores and get coupons I use websites like this https://contactsprice.com. The last time I bought year supply from Walgreens with almost 40% discount! ($10 checkout discount + 35% off coupon).

I also know that at Americasbest you can get an exam for contacts for $79  and free exam for glasses if you buy 2 pairs for $45 but they have not any stores in my location.
http://www.americasbest.com/schedule-eye-exam/

frugaliknowit

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Re: Is it cheaper to go without vision insurance?
« Reply #15 on: June 23, 2016, 10:00:13 AM »
I have never had vision insurance (really, what are you "insuring" anyway?), but can share a few things:

Contact lenses:  With prescription in hand, get a quote for a specific lens from a place or places.  Shop on-line.  My lens place will match any on-line price.  If they won't match it, buy them on-line.

Glasses:  Bricks and mortar Optical stores discourage replacing lenses by charging almost as much as new frames with lenses.  This is a marketing ploy designed to get you to buy new frames when the ones you have may be perfectly ok.  There are on-line optical stores that will replace lenses for a reasonable price (way, way cheaper than buying new frames and lenes).  Whenever my prescription has changed, I just ship them out.  I use replacealens.com.

BeardedLady

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Re: Is it cheaper to go without vision insurance?
« Reply #16 on: June 23, 2016, 10:08:02 PM »
If a vision plan is paid for or partially paid for by an employer, go for it. Buying a vision plan on your own almost never works out in the patient's favor. Services and testing related to ocular diseases (glaucoma, diabetic retinopathy, macular degeneration, cataracts, etc) are usually billed to medical insurance, and a vision plan will not pay for any of it. Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

I am of the opinion that insurance should be for unexpected expenses, not routine care. Vision plans and dental plans are priced such that you almost never come out ahead, and on the rare occasion that you do it is because your doctor took a significant pay cut to see you.

SimplyMarvie

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Re: Is it cheaper to go without vision insurance?
« Reply #17 on: June 24, 2016, 02:07:58 PM »

You can usually get a LASIK consult for free.  Go see if you qualify before making any insurance decisions.  I qualified for (and got) LASIK but DH did not.

MTA: Your vision insurance may also give you a discount on LASIK which is definitely worth investigating.

We're overseas, so it's sadly not covered or discounted by insurance, but the prices here for LASIK are very competitive -- by which I mean insanely inexpensive in comparison to even the discounted ones the US. I qualify for it, and have picked the doctor and done the consult. I just need to work out whether it will go on this year's FSA or next year's FSA, depending on how much we need to spend on some dental stuff for the Mister. And, frankly, gathering my courage. I'm the world's biggest wimp about things in/at/around my eyes, so I'm terrified by this and yet am acutely conscious of my glasses cramping my style and desperately want rid of them.

Lake161

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Re: Is it cheaper to go without vision insurance?
« Reply #18 on: June 25, 2016, 05:55:06 AM »
Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

Do you have any experience with plans that provide at least some coverage for medically necessary lenses? My previous vision insurance through my employer covered it, but I'm not seeing anything with good coverage on the independent market.

BeardedLady

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Re: Is it cheaper to go without vision insurance?
« Reply #19 on: June 25, 2016, 07:59:47 AM »
Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

Do you have any experience with plans that provide at least some coverage for medically necessary lenses? My previous vision insurance through my employer covered it, but I'm not seeing anything with good coverage on the independent market.

I have not seen a vision plan that does not have good coverage for medically necessary contacts, but I do not take very many plans due to the heavy pay cuts the newer ones want us to take. It also varies by state. In my midwest area, VSP, Eyemed, and Blue View Vision all have 100% coverage for medically necessary contacts. It also may depend on your diagnosis. The diagnosis code has to be specifically stated in what the plan constitutes as medically necessary. Medical plans will sometimes cover the services and part of the cost of the lenses, but that varies even more and the included diagnosis codes are more limited.

Lake161

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Re: Is it cheaper to go without vision insurance?
« Reply #20 on: June 25, 2016, 09:13:52 AM »
Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

Do you have any experience with plans that provide at least some coverage for medically necessary lenses? My previous vision insurance through my employer covered it, but I'm not seeing anything with good coverage on the independent market.

I have not seen a vision plan that does not have good coverage for medically necessary contacts, but I do not take very many plans due to the heavy pay cuts the newer ones want us to take. It also varies by state. In my midwest area, VSP, Eyemed, and Blue View Vision all have 100% coverage for medically necessary contacts. It also may depend on your diagnosis. The diagnosis code has to be specifically stated in what the plan constitutes as medically necessary. Medical plans will sometimes cover the services and part of the cost of the lenses, but that varies even more and the included diagnosis codes are more limited.

The most expensive VSP plan on the individual market in CA only offers $150 per year toward a contact lens exam and the lenses, which wouldn't cover much for me.

EDIT: just looked up EyeMed. They do have full coverage for medically necessary lenses. Seems crazy that they will offer this on a $30/month plan, as they will clearly lose money on me, but I'm going to read the fine print to be sure and then apply.  Thanks for the tip!!!

« Last Edit: June 25, 2016, 09:24:49 AM by Lake161 »

La Bibliotecaria Feroz

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Re: Is it cheaper to go without vision insurance?
« Reply #21 on: June 25, 2016, 09:37:56 AM »
Another mention of Costco.

I needed new lenses because my prescription changed a lot very quickly and my insurance wouldn't cover a new set of lenses after less than a year. They did say I could get 20% off.

My in-network eye doctor told me that with 20% off, the LENSES ALONE would be $232. (Transitions, etc.)

Costco? $108. $90 for the lenses and $18 to make a pattern for my frames since they hadn't come from Costco.

I might have been able to get a whole pair of glasses online cheaper, but I didn't have the mental energy to learn how to do that and pick out new frames.

BeardedLady

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Re: Is it cheaper to go without vision insurance?
« Reply #22 on: June 25, 2016, 09:44:38 AM »
Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

Do you have any experience with plans that provide at least some coverage for medically necessary lenses? My previous vision insurance through my employer covered it, but I'm not seeing anything with good coverage on the independent market.

I have not seen a vision plan that does not have good coverage for medically necessary contacts, but I do not take very many plans due to the heavy pay cuts the newer ones want us to take. It also varies by state. In my midwest area, VSP, Eyemed, and Blue View Vision all have 100% coverage for medically necessary contacts. It also may depend on your diagnosis. The diagnosis code has to be specifically stated in what the plan constitutes as medically necessary. Medical plans will sometimes cover the services and part of the cost of the lenses, but that varies even more and the included diagnosis codes are more limited.

The most expensive VSP plan on the individual market in CA only offers $150 per year toward a contact lens exam and the lenses, which wouldn't cover much for me.

EDIT: just looked up EyeMed. They do have full coverage for medically necessary lenses. Seems crazy that they will offer this on a $30/month plan, as they will clearly lose money on me, but I'm going to read the fine print to be sure and then apply.  Thanks for the tip!!!

That sounds like VSP's policy for regular contact lenses. Do they post anything separate for medically necessary contacts? It's crazy how much this varies by state.

Lake161

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Re: Is it cheaper to go without vision insurance?
« Reply #23 on: June 25, 2016, 09:58:51 AM »
Exceptions include those requiring "medically necessary" contact lenses. These can cost anywhere from a couple hundred dollars to thousands out of pocket for the lenses and related services, and between the vision plan reimbursement and the doctor's write-off they are typically covered at 100%.

Do you have any experience with plans that provide at least some coverage for medically necessary lenses? My previous vision insurance through my employer covered it, but I'm not seeing anything with good coverage on the independent market.

I have not seen a vision plan that does not have good coverage for medically necessary contacts, but I do not take very many plans due to the heavy pay cuts the newer ones want us to take. It also varies by state. In my midwest area, VSP, Eyemed, and Blue View Vision all have 100% coverage for medically necessary contacts. It also may depend on your diagnosis. The diagnosis code has to be specifically stated in what the plan constitutes as medically necessary. Medical plans will sometimes cover the services and part of the cost of the lenses, but that varies even more and the included diagnosis codes are more limited.

The most expensive VSP plan on the individual market in CA only offers $150 per year toward a contact lens exam and the lenses, which wouldn't cover much for me.

EDIT: just looked up EyeMed. They do have full coverage for medically necessary lenses. Seems crazy that they will offer this on a $30/month plan, as they will clearly lose money on me, but I'm going to read the fine print to be sure and then apply.  Thanks for the tip!!!

That sounds like VSP's policy for regular contact lenses. Do they post anything separate for medically necessary contacts? It's crazy how much this varies by state.
The VSP benefits have no mention of medically necessary. Davis Vision, another provider in CA had a larger allowance for exam and lenses for medically necessary, but not enough to cover more than half the cost. But EyeMed has full coverage for the lenses. I will have to pay for most of the exam (just a 10% discount on that). I checked that they cover my current optician (they do) and signed up.

Thanks so much for pointing me in the right direction. Love this community!