Supplemental Vision Insurance Plans

Posted: September 25, 2024

In California, you can access comprehensive health insurance through Covered California or the Affordable Care Act (ACA). However, vision care is not considered an essential health benefit. While certain Covered California health insurance plans offer some vision benefits, these plans only cover the basics. You’ll want to consider personal vision insurance if you have a family history of vision issues or wear glasses.

Supplemental vision insurance helps make eye care more accessible and affordable. It allows you to maintain your vision for a low monthly fee without putting yourself under financial strain.

How Supplemental Eye Care Insurance Works

Your vision insurance plan offers coverage outside your health insurance plan. You can either sign up for a stand-alone vision plan or combine your vision insurance with a dental plan. There are a few things to take note of, though:

• Under the ACA, vision coverage is not eligible for subsidies.
• Under the ACA, children’s vision care is considered an essential health benefit, with coverage under all Covered California health plans. It is not considered an essential health benefit for adults.
• Applications are open all year-round and do not require existing health insurance coverage.
• When you use eye care services, you may be required to pay a co-payment or deductible, so it’s important to know these amounts beforehand.
• Despite the possibility of co-payments, your plan may reimburse you for certain expenses. That means you pay upfront costs and submit a claim to get a portion of the costs back.
• It is essential to take note of your plans’ annual limits and how often you can get new contacts or glasses.

It is worth noting that qualifying, unreimbursed costs associated with your coverage may be tax-deductible. Some of your premiums may also be tax-deductible, along with additional costs that form part of your vision care plan.

Benefits of Supplemental Vision Insurance

Vision insurance often covers preventive and routine eye health expenses, such as contact lens fittings, eye exams, glasses and contact lenses. The accumulative benefits of this include:

• Cost savings: Without insurance, out-of-pocket expenses can add up. Supplemental vision insurance helps reduce these costs.
• Early detection: Access to regular eye exams can help detect health conditions or eye issues early so you can get timely treatment.
• Access to care: Supplemental vision insurance makes it easier to afford eye care, helping you address concerns and maintain good eye health.
• Flexibility: Many vision plans give you various options to find coverage that aligns with your needs.

Blue Shield Supplemental Vision Insurance in California

When you apply for vision service plan coverage, submit an online application to Blue Shield California. The vision benefits are administered by Vision Service Plan (VSP), a licensed service provider.

If you have an existing medical or dental plan, use the member identification number from your medical plan. Alternatively, register with the Blue Shield California vision plan administrator directly. They offer stand-alone coverage and supplemental vision plans.

Choosing the Right Supplemental Vision Insurance Plan

There is a wide range of plans available to you. Understanding the nuances will help you avoid getting overwhelmed by all the choices. Consider these factors during your assessment:

• Coverage needs: Make a list of services you need. Your list may include your routine exams, contact lenses, glasses or coverage for specific eye conditions. Remember that your health insurance may cover some eye diseases.
• Limits and exclusions: Understand the plan’s limitations, especially regarding your coverage needs. For example, some may restrict how often you can get new contacts or glasses.
• Network providers: Ensure that your preferred eye care professionals are in the plan’s network, as this will help you save money. Before applying, check the provider directory to find providers.
• Cost: Compare premiums, out-of-pocket expenses and co-pays to ensure the plan fits your budget. Some plans require a co-payment only when you do lens enhancements, although these plans come at a higher premium.
• Benefits: Some plans offer additional services like vision therapy or LASIK surgery. Review the plans that align with your budget carefully to ensure you get the extra benefits you need.
• Customer service: Consider the quality of your insurance provider’s customer service, which is important if you have questions about your coverage.

Frequently Asked Questions

Vision insurance plans vary across providers, so it is best to confirm the answers to any of your questions directly with your insurance provider. These are some general questions we see when Californians shop for Covered California vision insurance or supplemental insurance.

Do You Really Need Vision Insurance?

Many Americans rely on glasses or contact lenses to optimize their vision — about two-thirds of American adults, to be exact. If you are part of this group, supplemental insurance will help you save money while giving you more financial freedom, as you do not need to pay for eye exams or specs.

Are There Restrictions With Supplemental Vision Insurance Plans?

Supplemental vision care providers often have network providers that ensure you get discounted rates. If you have a preferred doctor, you must check that they are covered by the vision insurance plan you are considering.

Is It Worth Getting the Vision Insurance Plan With the Most Coverage?

More coverage is always helpful, but these plans come with high premiums. It is best to opt for the plan that gives you the best coverage while comfortably fitting into your budget.

Can You Use Your Supplemental Vision Insurance Out of State?

Some insurance plans allow you to use your benefits out of state. However, checking the fine print on your plan is crucial to confirm if your coverage extends while traveling outside of California.

Can Anyone Enroll in Vision Insurance?

If you are 18 or older and a lawful California resident with a Social Security number, you can select a stand-alone plan or supplementary coverage. Enrollment is open all year.

See Life the Way It Was Meant to Be Seen With Health for California

Knowing you have coverage reduces stress and makes managing your eye care expenses easier. Supplemental vision insurance plans can enhance your current eye health coverage beyond what standard health insurance plans cover. You have various plans from reputable providers to choose from, giving you access to comprehensive vision care that fits your budget.

Health for California strives to help you find the coverage you need to maintain your eye health. We offer easy, free and accurate application processes, allowing you to see which plans are available to you. Our agents are here for you, ready to answer questions and offer help if you are uncertain about anything.

Find vision insurance that suits you today. Contact Health for California with questions!