Enrolling in a vision insurance plan can help offset the cost of eyecare. However, you need to carefully to determine what your benefits include, what costs are involved, and who is on your network provider list. The following questions to ask your vision insurance plan administrator can help you learn what service you are entitled to and what is covered:
- What vision care services and products are covered (i.e. comprehensive eye exams, contact lens fittings, prescription lenses, etc.)?
- How often are vision care services and new glasses allowed? Once a year? Twice a year?
- Is there a deductible and how much is it?
- Am I responsible for a co-pay?
- Am I responsible for filing a claim or does my vision care provider file the claim for me?
- Do I need pre-approval or authorization before I receive vision care? Typically, your eye care provider obtains your eligibility and authorization on your behalf.
- Can I set up a flexible spending account (FSA) to cover my out-of-pocket vision care expenses?
When selecting an eyecare provider, make sure that they are an approved provider. Once you have selected an eye doctor, here are a few insurance-related questions to ask to make sure you are covered for the services you are seeking:
- Are you an approved provider for my particular vision care insurance plan?
- Are any of my vision problems considered a medical condition that should be filed under my medical insurance rather than my vision insurance?
- Do I file the claim with my insurers or will your office?
- Am I limited to only certain types of frames and lenses in order to be covered by insurance?
- Does my insurance plan cover multiple pairs of glasses, such as prescription glasses and prescription sunglasses?
- When should I schedule my next office visit, and how many visits a year does my insurance cover?
- Does insurance cover my needs or my child’s needs for prescription protective eyewear for the sports or activities we engage in?