Maximizing Vision Insurance Benefits

March 4, 2014 5:36 AM

Best use of vision insurance-glasses or contacts?

For the first time I'm going to be getting both contacts and glasses this year, but my insurance only covers one or the other. I need bifocals and high index lenses (and cute frames), and I really only want daily wear contacts. Based on my insurance coverage, should I use my benefits for glasses and pay out of pocket for contacts or vice versa?

VSP Insurance $15 exam copay

Contacts: $150 allowance for contact lens exam and contacts.

Prescription Lenses: $15 copay for lenses and/or frame.
$55 copay for standard progressive lenses
$95-105 for premium progressive lenses

Frame: $150-170 allowance depending on brand

Thanks for help deciphering my benefits!

posted by hollygoheavy to Health & Fitness (7 answers total)

I just did this! Do you have an FSA? I used my FSA to pay for the contacts and what my glassses cost over what VSP covered. I based my decision to use insurance to pay for (premium progressive) glasses because I wear them every day so having the best possible was key for me and I only wear contacts occasionally.

I still have my itemized receipts so memail me and I can share what everything cost if that would be helpful.
posted by pointystick at 5:46 AM on March 4, 2014

Spend it on contacts, then get a $20 pair of glasses online. I've had great luck with Zenni Optical, although there are other similar vendors out there.
posted by Gee Your Hair Smells Terrific at 6:12 AM on March 4, 2014 [2 favorites]

Best answer: This is going to be less about maximizing and more about what's most important to you: vision or price.

If vision is super important to you, Bifocals + High Index lenses = use your benefits for glasses, for sure. I always need high index (no bifocals yet, but soon I'm sure) and have used several of the online glasses retailers. While I've been reasonably happy with them, none look as good, are as light, or provide as sharp vision as the ones the optician at my optomotrist's office orders for me. If you want the best vision, use your insurance towards the glasses, then order the contacts through one of the mail order services that discounts based on quantity or subscription.

If price is more important and you can deal with your vision potentially not being great, go with vision benefits for the contacts and cheap online glasses. PD will be super important to get right if you do this, given that I'm assuming you have a pretty heavy prescription.
posted by marmago at 6:26 AM on March 4, 2014 [1 favorite]

Best answer: Something important to check: for the portion of your glasses price that isn't covered by insurance, do you get a discount? I have VSP and my benefits are similar to yours, but I get some percentage off the rest of the glasses price. This makes it a better deal to use the coverage for glasses and pay cash for contacts. Even if you don't have this as part of your plan, the optical shop might have a policy like this.

A lot of people will tell you to get glasses online, which is probably great for single vision and not super strong prescriptions, but with bifocals you really need to go to a good shop and get it done by a pro.
posted by radioamy at 7:24 AM on March 4, 2014

Best answer: I was just in a similar situation last week. What you need to do is sit down with the optometrist and pick out the exact glasses you want, and then run the numbers. See what the glasses + contacts would cost you if you used your benefit for the glasses and paid for the contacts out of pocket, and then run the numbers if you paid for the glasses out of pocket and used the benefit for the contacts. I couldn't get a good grasp of how much things would cost until we actually sat down and did the math.

I also usually alternate: contacts one year, glasses the next, and then use up my contacts half as fast as I should (I get 3-month disposables and wear them for 6; for dailies you'd wear them for 2 days before tossing) to make them last longer, until I was eligible for my benefit again.
posted by rabbitrabbit at 8:16 AM on March 4, 2014 [1 favorite]

(FWIW, I too also have the glasses percentage discount that radioamy mentions above, and this made it a better deal to use my $150 benefit on the contacts. Here are my actual numbers, for illustration:

Benefit used on contacts:
Glasses $318 - 30% discount = $222.60
Contacts $135 - $150 benefit = free
Total $222.60

Benefit used on glasses:
Glasses $318 - $150 benefit = $168
Contacts $135 out of pocket
Total $303

Hope that helps. Like I said, it was hard to know until I looked at the exact numbers.)
posted by rabbitrabbit at 8:35 AM on March 4, 2014 [1 favorite]

If vision is super important to you, Bifocals + High Index lenses = use your benefits for glasses, for sure.

Absolutely this.
I wear progressive trifocal high-index lenses. Based on the cost, I think they make the things out of unobtanium. I am jealous you have VSP. That's the gold-standard when it comes to vision coverage.
posted by Thorzdad at 8:44 AM on March 4, 2014