Vision Insurance 101: Is It Worth Offering as a Benefit?

Many small business owners treat vision insurance as an afterthought. It tends to be discussed briefly, maybe bundled alongside dental, and rarely given the same attention as medical coverage. But for employees, vision benefits can be some of the most consistently used benefits an employer can offer.

Vision insurance operates differently from medical insurance. Rather than protecting against unpredictable, high-cost events, it is designed to cover routine, predictable care. Most vision plans work on an allowance-and-discount model.

Most standard vision plans include the following services.

Annual eye exams.  A comprehensive eye exam is typically covered once per year, often with a small copay of $10 to $25. These exams check for changes in vision as well as early signs of conditions such as glaucoma, macular degeneration, and diabetic eye disease.

Prescription eyeglasses.  Plans provide a set allowance toward frames and a separate allowance or full coverage for prescription lenses. Standard lens coatings and enhancements, such as anti-reflective coating or progressive lenses, may be covered at a reduced cost or discounted through the in-network provider.

Contact lenses.  Most plans offer a contact lens allowance that can be used as an alternative to the eyeglass benefit, not in addition to it. Employees choose each year whether they want to apply their benefit to glasses or contacts.

Discounts on additional purchases.  In-network providers typically offer discounts on a second pair of glasses, sunglasses, or lens upgrades that fall outside the standard coverage.

Most standard vision plans do not cover elective procedures such as LASIK surgery (though some plans offer a discount on those services), treatment for eye diseases or injuries (which falls under medical insurance), and cosmetic items.

Vision coverage is one of the most affordable benefits an employer can offer. Group vision premiums typically range from $5 to $15 per employee per month for employee-only coverage, depending on the plan and carrier. Adding dependent coverage increases the premium, but vision remains one of the least expensive lines of group coverage available.

Eye care appointments are something most adults need on a regular basis. The American Optometry Association recommends that adults have a comprehensive eye exam at least every one to two years. For people over 60 or those with risk factors such as diabetes or a family history of eye disease, annual exams are standard.

Despite that recommendation, cost is a common reason people skip eye appointments. Without insurance, a comprehensive eye exam can cost $100 to $200. A pair of prescription eyeglasses with standard lenses can easily run $200 to $400 at retail. Contact lenses for a year can cost $300 or more. These are not trivial amounts, and they typically can increase year over year.

Annual eye exams do more than update a prescription. An optometrist examining the back of the eye can detect early indicators of serious systemic conditions including high blood pressure, diabetes, high cholesterol, and certain autoimmune disorders. In some cases, an eye exam identifies a health concern before the patient has noticed any symptoms.