How to Hack Vision Insurance Plans
Vision plans have only one benefit. That is one routine exam per year and one pair of glasses or contact lenses. They cover almost nothing on top of that. In fact, you’ll be quickly handed off to your medical insurance for anything outside of your routine eye exam and glasses/contacts. Vision plans are not “insurance,” but an odd type of savings plan for a yearly exam and glasses.
Vision plans are not “insurance,” but an odd type of savings plan for a yearly eye exam and glasses.
Once you are enrolled into a vision plan — either directly or through your employer — you are directed to an in-network doctor’s office to get your exam and buy glasses/contacts. Simply put, the doctors are required by the vision plans to jack up the price so they can give you a discount. If this sounds like a scam, it is. They complicate what should be a simple industry. Vision plans should be dismantled.
Until that happens, we all fall into one of two groups:
- You have a vision plan, or
- You don’t have a vision plan.
1. You Have a Vision Plan
You, or your employer, paid real money into the plan so you will want to use it one more time before dropping it during open enrollment. Here’s how:
Use Your Out-of-Network Coverage
If you shop for eyewear from a brand which does not participate in in-network vision plan discounting, then you will come out ahead. Here is a comparision taken directly from VSP’s “eyeconic” in-network website. It is very similar pricing to an in-network doctor’s office.
To make things more difficult, vision insurance plans do their best to make your available out-of-network reimbursement hard to find. However, there are ways around this. Some start ups are making it easier. For example:
2. You Don’t Have a Vision Plan
Good! Pat yourself on the back, you are part of a much needed change in the eyewear industry. For those who still have a plan, you’ll find this valuable information when considering dropping it.
Tell Your Optometrist You Don’t have Insurance
Let your OD know you no longer have a vision plan. Forward thinking OD’s will love you for it. Optometrists are tired of Vision Plans. If they didn’t need them to acquire patients, then they’d drop them. Tell your OD you dropped your insurance and would like to know if they offer pricing alternatives for service and products for patients without a vision plan.
Or Use Your Medical Insurance
Most people don’t know this, but most medical plans will cover your eye exam if you have a condition like: dry eyes, infection, corneal disorders, diabetes, a lazy eye, cataracts, glaucoma suspect, double vision, etc. If you suspect you may have one of these conditions, make sure you tell your doctor this when booking your exam. If you are responsible for anything out of pocket, it will only be for your eyeglass prescription — not the exam — and should be at a reduced rate.
Use your Flexible Spending or Health Savings Account
If your employer offers this, and you take advantage of it, you will be placing a portion of your income into an account tax-free. If your income tax rate is 30%, then you are basically receiving $30 for free, for every $100 put in. This can be used for your eye exam, your glasses, lenses, your prescription sunglasses, contacts, and many other things.
The key element to hacking vision insurance plans is to shop brands which do not participate in the in-network “discounting” scam.
Finally, Purchase Glasses From Direct Eyewear Brands
The key element to hacking vision insurance plans is to shop brands which do not participate in the in-network “discounting” scam. They provide simple transparent pricing. Not all eyewear is created equal, so make sure you know what you are buying. Here are some examples of direct brands:
Premium Quality (comparable to Oliver Peoples/Tom Ford): David Kind, Archibald, etc
Mid Market (comparable to LensCrafters/Visionworks): Bonlook, Lookmatic, Classic Specs, Warby Parker, etc
Discounters (comparable to Walmart Optical): Zenni, Coastal, etc
The average person or employer pays $135 a year into a vision plan. Only 25% of those enrolled in a vision plan use their benefit each year. Your unused money goes directly into the pockets of several large corporations like VSP, EyeMed, Davis Vision, etc designed with a single purpose — to keep this loop going. It is throwing money out the window and should be overhauled. The above is a better way. This is one of the reasons we started David Kind — to break the system together.