Eye Benefits Employees - Which Vision Insurance Plan?
There are many different insurance plans out there and a lot of times people get confused between their vision insurance and medical insurance. Sometimes they can be the same, like United Health Care, most of the time they can be seperate. You will have a vision insurance card that you should give to your optician or optometrist and the medical one to give to your primary care doctor.. If you accidentally give your medical insurance card, expect the poor sales rep to be checking each vision insurance company's web-site to see if that plan is under them.
There are actually 5 big vision insurance companies: VSP, Eyemed, Versant, Spectera, and March. There are other smaller/less popular ones like NVA, Metroplus, Superior, and other Union plans, but let’s just go over the big ones. Most of the medical vision plan companies that you know, like United health, Aetna, and Emblem health have their vision plan under these companies.
Let’s start with VSP. VSP is one of the most popular vision plans out there. It owns Marchon, one of the leading eyewear manufacturers who own brands such as Nike, Ferragamo, Lacoste, and Calvin Klien. A lot of times there is an additional discount when you purchase a Machon brand eyewear. A lot of big companies provide VSP and the frame benefits for them are rather generous. It averages around $150+20% for frames and they have small co-pays for your examination and for different types of lenses. One of the most generous plans I encountered was three frames per year with an allowance of $300 each. I wondered what company provided such a plan and the answer was: Facebook.
One big drawback for VSP is that the practice must be 51% owned by a doctor for it to accept VSP. This severely limits the amount of optical’s that accept VSP and if they do, a 51% doctor owned optical may not have the best eyeglass styles. Luckily, Mott Optical Group Store does accept VSP and the best place to buy glasses online with insurance with great brands and styles in NYC.
The biggest insurance company is Versant. It is not a household name because it was recently created by Superior vision and Davis vision joining forces. It’s ownership has changed a lot but after a few private equity hand-offs, it was finally acquired by Metlife. Most medical plans like Fidelis and Healthfirst go under Versant health. In terms of the benefits, they cover the broadest categories. For medicaid plans, it covers exams and frames and lenses, but the frames and lenses they provide are incredibly limited and take 2-3 weeks to complete and send back to the optician. For the professional plans, it’s typically 100-150 dollars off the complete frame pulse 15%-20%.
Another big vision insurance plan is Eyemed. Eyemed is owned by Luxottica, the largest eyewear company in the world. They partnered with Emblem health and Aetna so if you have these as your medical insurance, most likely Eyemed would be your vision plan. Their plans skew more towards professional discount plans and less so of the medicaid free plans. Just like Versant and VSP discount plans, it will have an allowance for the frame and different co-pays for exams and lens upgrades. One issue for Eyemed is that you may think that an optical accepts Eyemed but they have special plans that only certain doctors can accept and, in some cases, only Lenscrafters can accept. This sometimes confuses the customer and has them going to a “Eyemed approved” optical and realize they don’t accept their specific Eyemed plan.
The fourth Vision plan is Spectera. Opticals have a love/hate relationship with Spectera. On one hand, their benefits for the patients are great. Their medicaid plan which they partnered with United Health, offers a $300 dollar allowance for frames which is great. Their professional plan offers up to $150 dollars and sometimes even $180 off with 30% off on top of that. They are incredibly generous to their members. Unfortunately, that free money comes out from the optical where they reimburse the optical only a fraction of the allowance they give to the patient. This led to fewer and fewer opticals taking Spectera or the optical only offering the allowance and not the discount on top of it.
Finally, we have the most popular medicare plan, March. This is a vision plan that also partners with United Health. This is the most straightforward and easy plan for the optical and for the patient: Free exam plus $300 dollars whatever you want: frame and lens, only frame, only lens. Your choice. No confusing co-pays or certain lenses they cover and some they don’t. The optical also gets reimbursed almost dollar for dollar. A small drawback is that this benefit is offered only once every two years.
Lucky for you. Mott Optical accepts all these New York State vision insurance plans so come by and save money when you purchase eyewear.