Does vision insurance cover contact lenses
Does Vision Insurance Cover Contact Lenses?
Contact lenses are a convenient vision correction option for those who can’t wear glasses, aren’t eligible for corrective surgery, or prefer contacts. Understanding whether your vision insurance covers contact lenses is essential for managing eye care costs. This guide explores contact lens allowances, coverage for glasses and contacts, out-of-pocket expenses, and more.
What is a Contact Lens Allowance?
Many vision insurance plans include a contact lens allowance, a set annual amount allocated for purchasing contact lenses. Typically, this allowance ranges from $100 to $200 per year, depending on the provider and plan. For example, a basic plan might offer a $150 allowance, which can offset the cost of daily, bi-weekly, or monthly lenses. Check your plan details to confirm the exact amount and any restrictions.
Does Insurance Cover Glasses and Contacts at the Same Time?
Some vision insurance plans cover both glasses and contact lenses, but most require you to choose one per benefit period (usually annually). This means you may need to decide whether to use your allowance for glasses or contacts. Some premium plans, however, offer flexibility to cover both partially. Review your policy or contact your provider to understand your options. For more details, visit MetLife’s guide on vision insurance.
Are Glasses Cheaper Than Contacts?
The cost of glasses versus contact lenses depends on factors like lens type, frame quality, and replacement frequency. Glasses are often a one-time purchase lasting several years, with costs ranging from $100 to $500. Contacts, however, require regular replacements, with annual costs typically between $200 and $600. Daily disposable lenses may be pricier but offer convenience. Budget-conscious individuals may find glasses more cost-effective over time.
What is Not Covered by Eye Insurance?
Vision insurance typically excludes:
- Non-prescription eyewear: Sunglasses without a prescription are not covered.
- Cosmetic procedures: LASIK or other elective surgeries are usually excluded unless specified.
- Non-medically necessary contacts: Cosmetic lenses (e.g., colored contacts without vision correction) are not covered.
For more on vision insurance exclusions, check VSP’s vision insurance guide.
How Much Are Contacts Out of Pocket?
Without insurance, contact lens costs vary based on lens type and prescription. On average, expect to pay $200 to $600 annually for lenses alone. Specialty lenses, like toric lenses for astigmatism or multifocal lenses, can cost more. Including eye exams ($50–$100) and contact lens fittings ($50–$150), total out-of-pocket costs may range from $300 to $800 per year. Compare prices at retailers like 1-800 Contacts for savings.
Coverage When Contacts Are Medically Necessary
Contacts deemed medically necessary—for conditions like keratoconus, anisometropia, or severe refractive errors—often receive enhanced coverage. Insurance may cover a larger portion of the lenses, fittings, and exams, reducing out-of-pocket costs. Documentation from your eye care provider is typically required to qualify. Consult your plan or provider for specifics on medically necessary contact lens coverage.
Frequently Asked Questions
Does vision insurance cover contact lenses?
Yes, most vision insurance plans cover contact lenses through an annual allowance, typically $100–$200, but coverage varies by plan.
Can I use vision insurance for both glasses and contacts?
Most plans require you to choose either glasses or contacts per benefit period, but some premium plans may allow partial coverage for both.
What are medically necessary contact lenses?
Medically necessary contact lenses are prescribed for conditions like keratoconus or severe refractive errors, often receiving enhanced insurance coverage.
