If you wear glasses or contacts, or have kids in glasses and contacts, you may be wondering whether vision insurance is a good choice for you. Depending on your options for coverage and how many people will use the benefit, insurance may save you a few or a few hundred dollars each year.
Tricare Vision Coverage
Military and retiree families are able to purchase vision insurance through the Federal Employees Dental and Vision Insurance Program (FEDVIP). Depending on your family’s situation, vision insurance can be a great way to lower your out-of-pocket spending on vision care, glasses and contacts.
As you probably know, Tricare covers one eye examination each year for active duty families, one eye exam every two years for retiree families on Tricare Prime, and doesn’t have a vision benefit for retiree families on Tricare Select. Folks using USFHP may have vision coverage, depending. Tricare does not cover contact lens fittings, anything special (like those retinal photographs that are recommended), or any contribution towards glasses or contacts. This means that families with vision needs may benefit from a separation vision insurance policy.
My family has a private vision policy through VSP Direct and it saves us hundreds of dollars each year, but we have SIX people with more complex vision needs and max out our contact lens and/or eyeglass benefit every single year. For vision plans, there is definitely a break-even point that depends on your family size and your vision needs. So, how do you decide if you want to purchase vision insurance, and how do you decide which plan is right for you?
What Are Your Vision Insurance Options?
Active duty families have access to the FEDVIP vision plans or can purchase a commercial policy. They may also have access to vision insurance through a spouse’s employment.
Retiree families may purchase coverage through the FEDVIP program, and s may have access to vision insurance through the retiree’s employer or spouse’s employer. They may also choose to purchase a commercial policy.
Each option may present different variables depending on your specific situation.
The FEDVIP has a wide variety of plans, convenient payroll deduction, and has a self (translate: spouse), self plus one (translate: spouse plus one child), or self plus family (translate: spouse plus multiple children) option. One downside to the FEDVIP plans is that the active duty service member is not eligible for coverage – this can be key if the service member wears contacts or would like to purchase glasses beyond that offered by the military. FEDVIP plans can only be purchased during the open season (usually the second Monday of November to the second Monday of December each year) or if you have a qualifying life event.
Employer-sponsored coverage may by subsidized by the employer, making it less expensive than FEDVIP or commercial plans. Your employer offerings can be amazing or they can be lousy – you really have to evaluate the plan you have available and compare it to your needs. Both the cost and who can be covered will vary by plan.
Commercial coverage can be a popular option because it doesn’t require an open enrollment period or a qualifying life event – you purchase a year’s worth of coverage and then decide whether to renew each year. I even got coverage through VSP Direct for an appointment in a few days, instead of waiting for a new month to start. That was really helpful for us when I randomly decided to purchase it mid-year. Plus, commercial coverage can cover the active duty service member, at no extra cost if you’re already purchasing family coverage.
How Much Does Vision Insurance Cost?
Premiums for coverage are based upon your family size and your location. For larger families, there are usually significant savings because there are usually three premium points: single, two person, and family (more than two persons.) The relative cost between the three levels varies by plan, but you don’t pay more if you have five, six, or more in your family.
The VSP Direct commercial insurance I have costs me just under $400 per year for family coverage. FEDVIP plans range in costs from $80 per year for a single person to over $500 per year for a family. The difference in price depends on your location and the coverage of the plan – more expensive plans have more coverage.
What Does Vision Insurance Cover?
Vision insurance typically covers exams and some level of allowance towards contact lenses and or eyeglasses. There may be a co-pay or cost-share for these services. Vision insurance can also offer add-ons like scratch-resistant coatings or transitional lenses for free or at a reduced cost. You may also get discounts on extras like retinal photography, or vision surgery like Lasik.
One thing to compare, if you wear contact lenses, is whether it gives you a cash allowance towards contact lenses or if it gives you a set number of boxes. If it is a set number of boxes, be sure your lenses are covered, and consider the actual cost of your lenses.
Is Vision Insurance Worth It For Your Family?
Whether vision insurance is a good value for you depends on your family size and your vision situation, particularly since the family premium does not continue to go up with more people. If you have a smaller family, or don’t spend money on upgraded services, vision insurance may not be right for you.
Start by figuring out how many people you’ll be covering. Because of the way coverage is written, this is essential for figuring out which plan is right for you. Then, look at the individual plans and see how much they cover and/or you’ll pay for eye exams, glasses, contact lenses, and extra services. Then compare how much they’ll pay with the cost of the premiums.
I know, it’d be easier if I could just tell you which plan is right for you. But I can’t – it’s too individual. But I can tell you how I did the math for my family. As I said before, our VSP Direct policy costs us just under $400 per year, and it covers $150 per person towards glasses and contact lenses. I don’t even have to figure out all the added benefits, because $150 times 6 people is $900 – I’m saving $500 per year even if we don’t get a discount on add-ons and extra services.
Do You Want The FEDVIP Vision Insurance, or Other Vision Insurance?
This is a tricky question.
If you have access to another employer-sponsored plan, that is often going to be a more affordable choice because there is usually some level of employer subsidy.
If you’re choosing between the FEDVIP options or commercial insurance like VSP Direct, there are several things to consider.
First is cost. In our case, our commercial VSP policy is more expensive than the same FEDVIP plan. But it has difference coverage.
Second is convenience. You don’t have to wait for an open season, and you can start benefits immediately. (If you call them, and pay for the current month, you can even be seen without waiting for the next month to start.)
Third is the coverage of adult children. Our VSP Direct policy covers our adult children to age 26. FEDVIP plans drop them at 21, or 23 if they are in college full time. Adult children on Tricare Young Adult are not eligible for FEDVIP coverage – they’re on their own if you choose a FEDVIP plan.
Lastly, it is worth considering whether you want coverage for the service member. Active duty service members are not eligible for coverage under FEDVIP plans, but they are eligible for coverage under commercial policies like VSP Direct. My husband is covered under our family’s VSP Direct plan at no additional cost and it lets him get more stylish glasses than the Navy offerings. This is also great if your service member wears contact lenses – my plan covers $150 per year in contact lenses in lieu of glasses. If your service member would like additional eyeglasses or contact lens coverage, you’re going to want an employer plan or a commercial policy.
Why My Family Uses A Private Policy
When I first started researching vision insurance, I had four kids who needed exams (yesterday!) and there was no plan available through the military. I went to USAA and found that they have a relationship with VSP Direct. After exploring the VSP Direct plan, it sounded good, but I needed benefits to start sooner than the next month (which is how it works if you go through USAA.) So I went to VSP directly, and discovered that the plan was the exact same price, with the exact same coverage, and if I was willing to pay for the entire month I was in, I could have it effective in a few days.
I’ve now compared my private VSP Direct plan with the one offered by the FEDVIP program and it is a smidge more expensive to purchase it privately – but there is a good reason that it is worth it to me. I pay $399.48 per year for family coverage, and the same plan through the FEDVIP program would be $278.52 Plus, my private plan co. But for that extra $120 a year, I got to buy in whenever I needed to, it covered my husband while he was still on active duty (FEDVIP plans don’t) and it covers my kids who are on Tricare Young Adult. Now that my husband is retired, and would be covered under the FEDVIP plan, we’re still sticking with this private policy to cover our older kiddo. When we eventually don’t have any kids on TYA, then we’ll probably switch solely to the FEDVIP plan – or even pay out of pocket vs. carrying insurance.
But we are also carrying a FEDVIP plan so that we have double coverage. It doesn’t cover my TYA kiddo, but it gives us twice the glasses/contact lenses coverage each year. And since all six of us wear glasses, and five wear contacts, that pays off for us.
Where Can I Find More Information?
You can find more about the FEDVIP offerings at the Tricare Benefeds website: https://www.tricare.benefeds.com/InfoPortal/indexAction. There is an option to “compare” policies, but it really only scratches the surface of the plans. You really have to download the actual PDF brochure in order to do a proper comparison.
Here’s a link to the VSP direct plan I purchased as an individual. It’s been good for us, and we’re sticking with it. VSP makes it easy to save money, care for the health of your eyes, and look good – all at the same time. And, your satisfaction is backed by a 100% satisfaction guarantee.
In case you haven’t been keeping up with all the other changes happening with this new Open Season plans, you should definitely read these articles: