Excellent question and one about which there is much confusion these days. As a general rule, most health insurance policies do not cover routine eye exams (this would be different from an eye exam required to diagnose and/or treat a medical condition like Macular Degeneration). Many employers and a growing number of individuals insure their vision care needs through separate Vision Insurance policies that do cover eye exams, lenses, frames, contact lenses, etc..
Where things get more confusing, and sometimes frustrating for the consumer, is in understanding some of the new benefits mandated by the Affordable Care Act (ObamaCare). One of these mandatory benefits is that coverage for pediatric vision and dental be included in health insurance policies sold on or after January 1, 2014. So, you may be paying for a vision benefit that only your children can use and if you have no children you are paying for a benefit you, as an adult, cannot use.
The consumer should not assume that even if their new ObamaCare compliant policy is in place that this will translate into effective coverage for your dependent children. Each insurance carrier has designed their benefit plans differently in regard to the vision & dental requirements. Some make it an upfront benefit similar to vision insurance coverage you may have seen in the past while others require that the major medical plan's deductible be met before such services would be reimbursed. So, if you have a Bronze plan with a $6000 deductible you technically have some vision coverage for dependent children but no effective coverage until you have met the $6000 deductible first.
Buyer beware is my advice and the consumer should carefully research this benefit area in the various health insurance options you might be considering. This is another example of where an experienced and knowledgeable health insurance broker can be invaluable in helping you select the health insurance plan best suited to your needs and budget.
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Where things get more confusing, and sometimes frustrating for the consumer, is in understanding some of the new benefits mandated by the Affordable Care Act (ObamaCare). One of these mandatory benefits is that coverage for pediatric vision and dental be included in health insurance policies sold on or after January 1, 2014. So, you may be paying for a vision benefit that only your children can use and if you have no children you are paying for a benefit you, as an adult, cannot use.
The consumer should not assume that even if their new ObamaCare compliant policy is in place that this will translate into effective coverage for your dependent children. Each insurance carrier has designed their benefit plans differently in regard to the vision & dental requirements. Some make it an upfront benefit similar to vision insurance coverage you may have seen in the past while others require that the major medical plan's deductible be met before such services would be reimbursed. So, if you have a Bronze plan with a $6000 deductible you technically have some vision coverage for dependent children but no effective coverage until you have met the $6000 deductible first.
Buyer beware is my advice and the consumer should carefully research this benefit area in the various health insurance options you might be considering. This is another example of where an experienced and knowledgeable health insurance broker can be invaluable in helping you select the health insurance plan best suited to your needs and budget.