Table of Contents
Key Takeaways:
- Even if you have vision insurance, going to the optometrist can mean paying hundreds out of pocket.
- Many Oklahomans don’t understand their coverage well because of exclusions and limits hidden in the fine print.
- Vision care costs are up, and with traditional insurance giving you access to limited coverage, it’s time to explore pre-paid plans.
If you’re using traditional vision insurance in Oklahoma, chances are your last trip to the eye doctor included an unexpected bill. Whether it was for scratch-resistant lenses, anti-glare coatings, or a basic exam, many patients are finding their out-of-pocket costs don’t match the plan summary.
These aren’t one-off surprises; they’re built into how most vision plans work. From hidden exclusions to lab restrictions and confusing coordination-of-benefit rules, the fine print is getting harder to ignore.
What’s Not Included in Most Vision Plan Summaries
You’re buying vision insurance to save money, but, unless you review the fine print carefully, your coverage is likely full of gaps. What your plan doesn’t cover is often what drives your bill up at the optometrist.
Here are some common examples of products and services most plans don’t cover:
- Coatings. When getting a new pair of glasses, coatings can protect the lenses from scratches and limit UV exposure. These must-have features often come out of your own pocket.
- Specialty lens coating fees. Add-ons like blue-light filters and anti-fatigue coatings will increase the cost of your new eyeglasses.
- Progressive lenses. Many plans don’t cover these corrective lenses, even though they’re the best option for many patients.
- Contact lens fitting fee. If you’re picking contacts over eyeglasses, prepare yourself to pay a fitting fee your plan won’t cover.
- Advanced testing. Your optometrist might recommend additional tests your plan doesn’t reimburse, like retinal imaging or a dry-eye evaluation
- Lab exclusions. Vision plans have agreements with labs and only reimburse products from their preferred labs. If you need a product from a different lab, you’ll have to pay for it yourself.
- Out-of-network costs. Traditional vision insurance providers have a network of optometrists who accept their plans. If you can’t get an appointment in time, you’ll have to go out of network and get little to no coverage.
On top of excluding products and services from the coverage you pay for, vision plans also have limits. This usually means you can only get reimbursed up to a certain amount within the year, or get one pair of glasses a year. Anything above your annual limit will come out of your own pocket.
Navigating these exclusions and limits is difficult because this information is often hidden in the fine print and not clearly disclosed when you buy your plan.
What’s Driving Vision Care Costs Up in Oklahoma?
Paying for limited vision insurance coverage is only half of the issue. Your out-of-pocket expenses are high because good vision care costs more. Here’s why.
The obvious answer is that inflation is up, and health care costs more overall. Optometrists and labs face higher costs and must charge more for their services. Plus, Medicare is lowering reimbursement rates for optometrists, which means many insurers are following this trend, and optometrists are charging more to make up for the lost reimbursements.
There is also a consolidation trend shaping the eye health care industry. A few large companies control most of the market and drive prices up. In Oklahoma, it’s still possible to find many smaller independent practices and labs with great prices. Make sure you take advantage of this!
The other reasons behind these higher prices are good news:
- Vision care is getting better thanks to tech. Eyeglasses use high-quality materials, you can get contacts with advanced features, and optometrists have access to smart machines for better diagnoses. However, these innovations cost a little more.
- Optometrists are taking a more customized and patient-centric approach to providing care. It means they’re more likely to recommend add-ons your insurer didn’t pre-load. It’s not an upsell, it’s a treatment plan that matches your unique needs.
Even if you’re a pro at navigating vision insurance coverage, it’s hard to avoid higher costs because of these factors. For many Oklahomans, switching to a prepaid plan is the answer.
What Makes Prepaid Vision Plans Different (and Better for Your Wallet)
With a pre-paid vision plan, you don’t get reimbursed after your trip to the optometrist. Instead, your plan unlocks savings on eye care that have been negotiated ahead of time with in-network optometrists. It makes a huge difference because the savings are usually much higher compared to what a traditional insurance plan would reimburse you.
Plus, prepaid plans use simple structures. You get a simple list of the savings available on eye health products and services, with no complex limits or exclusions hidden in the fine print. You know exactly how much you’ll save, and there are no surprises when you get your bill.
Reduce Your Vision Care Cost in Oklahoma With VCD
Are you tired of vision plan sticker shock? It’s time to replace your traditional insurance plan with a prepaid product. You’ll save more, and with VCD, you’re getting a patient-first plan that is owned by doctors.
Our plans give you access to one of the largest networks of optometrists in Oklahoma, with plenty of local businesses to support. There are no lab restrictions, and you’ll get great savings on eye exams, eyewear, LASIK surgery, and more.
Learn more about VCD’s prepaid plans here.
FAQ
How do annual limits work with traditional vision insurance?
Most vision insurance plans have annual limits on the total amount you can get reimbursed, how many eye exams are covered, or how many eyeglasses you can get. If you exceed these limits, you’ll pay out of pocket.
Why are prepaid vision plans cheaper than insurance?
Prepaid vision plans give you access to savings at the optometrist rather than reimbursements. These savings are usually higher than the amount a traditional insurance plan would reimburse, making prepaid plans the better value.
Why are there eye exam out-of-pocket costs even if you have insurance?
Most plans come with co-pays. You might also need add-ons your plan doesn’t cover, such as advanced testing or a contact lens fitting.
Does vision insurance cover LASIK?
It depends on your coverage, but most entry-level plans don’t cover LASIK. VCD’s prepaid plans are an affordable alternative if you’re looking for savings on LASIK surgery.
