Vision Open Enrollment

Like dental, vision isn't in your health plan (except pediatric vision, which is an essential health benefit for kids). Adult vision coverage is a separate, inexpensive product — but the market is full of discount plans masquerading as insurance. Here's how to tell the difference and choose well.

Real vision insurance vs. discount plans

• Real vision insurance: pays defined benefits — exam copay, glasses/contacts allowance, lens options covered at set rates. Premiums are low ($10-20/month is typical).
• Discount plans: no premiums paid to an insurer, just a membership card for percentage discounts. Not insurance — and the "discounts" are often off inflated list prices.
• The test: ask "what's my allowance and what's my copay?" If there's no straight answer, it's a discount plan.

What to compare

• Exam copay — usually $10-25 on real plans.
• Frames/contacts allowance — $130-200 is typical; check whether it's annual.
• Lens options — progressives, coatings, and high-index lenses are where costs hide; check the copay schedule.
• Network — your preferred optometrist or optical shop in-network? Out-of-network reimbursement is usually weaker.
• Frequency — exams every 12 months is standard; frames/contacts every 12-24 months.

Is it worth it?

Do the math against cash prices: if you wear glasses or contacts, one exam plus one pair of glasses usually exceeds the annual premium — vision insurance wins for most wearers. If you have perfect vision and just want an annual check, cash-pay exams may be cheaper. Contact lens wearers should check the contacts allowance specifically — it varies more than the glasses benefit.

Common vision mistakes

• Buying a discount plan thinking it's insurance — ask for the allowance and copay schedule; no straight answer means it's not insurance.
• Ignoring the lens-options copays — progressives and coatings are where the real costs hide.
• Not checking frequency — frames every 24 months vs. 12 changes the value math.
• Out-of-network optical shops — reimbursement is weaker; verify your shop first.

Pro tip: contact lens wearers — compare the contacts allowance specifically across plans; it varies far more than the glasses benefit.

The bottom line

Vision coverage is cheap and simple — the only real trap is the discount plan masquerading as insurance. Verify the allowance, check the lens copays, confirm your shop's in-network, and you're done.

Key takeaway

For most glasses and contacts wearers, one exam plus one pair of eyewear exceeds the annual premium — the insurance wins. Compare the contacts allowance carefully if you wear contacts, confirm your optical shop is in-network, and don't confuse a discount card with real coverage.

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