Learn More About Accepted Vision Insurance
We Work With All Major Health & Vision Plans Including
What You Need to Know About Vision Insurance
At Pearle Vision, we understand that navigating your vision insurance isn’t always easy. That’s why we’re here to help you. We want to make sure you’re taking full advantage of all the benefits your plan has to offer.
We’ve created a quick guide to help you understand commonly used insurance terms and answer some of our patients’ most frequently asked questions. If you don’t see yours addressed below, contact your local Pearle Vision EyeCare Center for more detail about our services and what insurance we accept at 1-800-YES-EYES.
What is an Allowance?
When you purchase a new pair of glasses, you’ll pay a separate price for your lenses and frames. Your allowance will only go towards your frames at a fixed rate. For example, your eye insurance may give you a $200 frame allowance. Meaning, you’ll pay nothing if you pick frames that are $200 or less. However, if they’re more than $200, you’ll pay the difference. We offer a wide variety of frames and price points, including designer brands such as Ray-Ban, Oakley, Coach and Vogue. You’ll want to keep your allowance in mind when selecting a new pair of glasses.
How Much Will I Pay Out-of-Pocket?
This depends on your individual plan and the eyewear you select. Understanding your co-pay and allowance is the first place to start. Be sure to check out your full benefit summary to confirm the benefits your plan covers.
What is a Co-pay?
When you visit an eye doctor, your co-pay is the fixed amount you’ll pay for the services you receive. There may be separate co-pays for an eye exam, your glasses and other services depending on your insurance. The cost of your co-pay will depend on your vision insurance.
What is Coverage?
The eye care services and materials listed as benefits in your vision insurance plan are the items that will be covered by eye insurance. In general, only specific services will be covered or offered at a discount in exchange for a monthly premium and/or co-pay. Most vision insurance plans will cover an annual exam and prescription eyewear, such as glasses or contact lenses.
What is a Deductible?
A deductible is the amount you must pay for vision care services before your plan pays its portion of the costs. For example, if you have a $1,000 deductible, you’ll pay $1,000 in services out of pocket and any covered expenses after that will be paid by your vision insurance. Typically, insurance plans have yearly deductibles that must be met, though things like an annual exam may be covered without having to meet the amount.
Certain plans may have separate deductibles for specific services, such as prescription drugs. If you’re on a family plan, your deductible may differ from the rest of your family members. How much you pay and what will be covered will vary depending on your eye insurance. In general, plans with a lower monthly premium will have a higher deductible and those with higher monthly premiums will have a lower deductible.
What Are Exclusions?
Exclusions are any services or items your plan’s insurance company will not cover. This may include pre-existing conditions, specific drugs or a type of surgery. In general, any elective procedures, such as LASIK eye surgery, will most likely not be covered by insurance.
Insurance Plans We Accept
We work with all major health and vision plans, including:
UnitedHealthcare: No waiting period means you can start using your vision plan immediately. Pay as little as a $10 copay for an eye exam, depending on your plan, when you visit an in-network provider. Visit the UnitedHealthcare page to find an EyeCare Center that is in-network.
VSP: This plan requires a 5-day waiting period. Depending on your plan, you may pay $15 for an eye exam and $25 for prescription lenses. Visit the VSP page to find a list of in-network EyeCare Centers.
TRICARE: This plan provides benefits for members of the Armed Forces and their families. Under this plan you’re covered for an annual exam at in-network locations. Visit the TRICARE page to find a list of EyeCare Centers that accept this insurance plan.
EyeMed: Utilize your EyeMed benefits on lenses, frames, non-prescription sunglasses and accessories, depending on your plan. All of our EyeCare Centers accept EyeMed insurance. To take advantage of everything your plan has to offer, visit a Pearle Vision EyeCare Center near you.
Can I Get an Eye Exam Without Insurance?
We want everyone to get the health care they need and deserve, which is why we accept any new patients with or without eye exam insurance. Contact your neighborhood Pearle Vision EyeCare Center ahead of time to request an estimate for the cost of an eye exam without insurance so that you can budget accordingly. If you don’t have insurance, be sure to ask about any available discounts or payment options.
Whether you’ve obtained your vision insurance through an employer, a family member’s plan or have purchased an individual eye care plan, take the time to review and understand your policy prior to accepting services. Being informed about your vision insurance can help ensure you’re getting the services you need without receiving an unexpected bill at the end. Our eye care experts are also here to walk you through the process and answer any questions you may have before, during and after your visit.
If you’ve reviewed your insurance and would like to come in for an eye exam, book an appointment at your local Pearle Vision EyeCare Center to take advantage of your vision insurance benefits.