Learn How to Choose the Best Vision Insurance Plan for You

The Affordable Care Act and vision insurance

All qualified health plans (insurance plans certified by the health insurance marketplace) are required by the Affordable Care Act (ACA, also known as Obamacare) to provide pediatric vision coverage, which includes an annual eye exam and some material benefits (such as eyeglasses), to all patients under the age of 19.

 

Most eligible health plans, however, do not provide adult vision coverage, such as coverage for refractive problems or minor eye disorders such as conjunctivitis. Adult vision coverage, which includes coverage for an annual eye exam as well as material benefits (eyeglass lenses, eyeglass frames, partial reimbursement for LASIK procedures, and so on), is generally a smart option for you to obtain.

However, if you have a major eye disease, such as glaucoma, cataracts, amblyopia, strabismus, diabetic retinopathy, or age-related macular degeneration, you can receive coverage for your eye disease through qualified health plans, as all of these ailments are generally considered medical problems and can be billed to your medical health plan. When necessary, many medical health plans may cover eye surgery, most typically for glaucoma and other eye problems.

Vision Insurance Plan: Frequently Asked Questions

Is Lasik surgery covered by vision insurance?

No. Because LASIK surgery is considered elective, it is typically not covered.

Is cataract surgery covered by vision insurance?

Surgery is not covered by vision insurance. This also implies that it does not cover cataract surgery, which is commonly deemed medically necessary. This operation may be covered by your health insurance.

 

Is eyewear covered by vision insurance?

No, regular sunglasses are not covered by vision insurance, but prescription sunglasses may be. Examine your strategy more closely to understand more.