Maricor Bunal
I have a confession to make: I have the maturity of a 6 year old, the appearance of a 16 year old, and the eyes of a 40 year old.
Gasp.
It’s time to grow up and think about things like insurance and going to the doctor.
I knew one day it would come to this. I just didn’t think it would be today.
No one batted an eye when I marched into the Build-A-Bear Workshop at the Galleria Mall this morning. They may have assumed I was deliberating over the perfect gift for my little girl when I chose a unicorn and a tutu; they possibly thought I was aiming for toy neutrality when I settled on some sort of strawberry scented Superman devil fox. But I don’t have a kid, and the man I hit in the parking lot thought I was a kid.
Unfortunately, I didn’t see him.
I don’t know why he was standing behind my car; that’s not the point. The point is: I hit a man with my car today, after playing with toys at the mall.
Twice.
I hit the man twice.
I thought he moved!
Next thing I know, he’s telling me he should call my parents…then he sees the fox…and assumes I am a parent…and I tell him I didn’t see him…and he tells me I need to get my eyes checked…So I do.
I knew the Galleria Mall has a LensCrafters, so I apologized profusely, got out of my car, and walked in. Maybe I was just trying to get away, but I really did need an eye exam. It’s been years.
Almost as soon as I walked in, the staff asked about my vision and medical insurance. I don’t live in Poughkeepsie – I don’t even live in America right now – so I was unable to use my insurance. But I was able to get an eye exam, my first pair of multifocals, gag, and a lecture about the importance of getting an annual eye exam. I was also able to do some research for you.
Vision and Medical Insurance
If this were you, you’d probably be wondering what the difference between vision and medical insurance is. That’s where I come in. As a work-from-home-writer, I may have developed some peculiar hobbies, and it’s probably a good thing I don’t drive much, but I make a living from researching important lifestyle topics so you don’t have to.
First of all, you should know that while both medical and vision insurance plans may cover some of the same benefits, they are distinctly different.
Medical plans typically cover the treatment and screening of vision-related medical problems and diseases like glaucoma, high blood pressure, and vision loss due to diabetes or cardiovascular disease.
Vision plans typically cover routine eye exams, frames, lenses, and contacts. Some plans even include LASIK reimbursement.
To give you an example of what optometry services are covered by vision and medical plan, I have compared 3 of the insurance plans my Poughkeepsie eye doctor accepts.
Aetna
Aetna offers vision coverage as a stand alone plan and as an addition to an existing Aetna plan. However, these plans are only offered through an employer. You cannot purchase these plans as an individual.
If you have an Aetna medical plan through your employer, you may have Aetna Vision which covers routine eye exams every 1-2 years and partial payment of glasses and contacts.
Even if you do not have an Aetna medical plan, you may be able to purchase Aetna Vision Preferred – available as a Standard or High Plan. These plans range from $6.96 a month for an individual on the Standard Plan to $37.79 a month for an individual and family on the High Plan.
Aetna Vision Preferred covers in-and-out-of network care and popular optical chains like LensCrafters and Pearl Vision. You may also get routine eye exams with no copay; low copayments for retinal imaging, lens treatments, multifocal lenses, and progressive lenses; from $140 to $230 to spend on contact lenses and eyewear, and up to 15% off LASIK laser eye surgery.
Summary: It’s unclear how much Aetna Vision costs, but Aetna Preferred offers bi-weekly and monthly fees as low as a latte from a popular coffee chain. Moreover, the copays are low and the allowances are high.
CDPHP
If you live in New York, you may have a Capital District Physician’s Health Plan (CDPHP)
available through individual and group plans. You may also purchase a plan as an individual.
For group plans, you may get a rate from your employer. Individual plans range from around $200 to around $600 a month – with deductibles ranging from 10-40%.
CDPHP group plans cover specialists in ophthalmology or optometry, pediatric vision, and annual or alternate-year eye exams and allowances for eyeglasses or contact lenses. LASIK reimbursement up to $750 may be covered by select plans.
CDPHP individual plans cover specialists which may include ophthalmologists and optometrists, medications which may include medical eye drops, children’s eye exams, and coverage for children’s eyeglasses.
Summary: CDPHP plans are expensive but may be worth it if you need a health plan.
EyeMed
EyeMed is only available through an employer but is available in 42 states. EyeMED offers Basic and Expanded Plans ranging from approximately $3.00 a month to $30 a month.
Benefits include low to no copay coverage for eye exams, frame allowances up to $115 every two calendar years, and additional discounts for contact lenses and add ons including lens options and specialty lenses. Savings also include up to 95% off the retail price for LASIK and 40% off an additional pair of glasses.
Summary:
This plan is cheap and may save you a couple hundred dollars a year.
Which Plan Would I Choose?
Given I now need to wear glasses – all the time – especially when driving in parking lots – or anywhere there’s people – and I have a history of losing things – I’d probably choose the plan with the most coverage for glasses and contacts. Did you know you can also get multifocal contacts? Anyway, I’m also considering LASIK – both of which are offered by all three plans, but would probably save me the most money with EyeMed. But it’s not that simple. If I need a new medical insurance plan, Aetna may provide me with everything I need, and I may like the medical benefits of a CDPHP plan. I’d encourage you to compare the medical benefits of various plans before choosing, but unless your vision is perfect and you are under 35, I’d choose a plan.
