Covered California is giving individuals and families another option for vision insurance with the addition of EyeMed vision plans in 2016. The new EyeMed plans compete against the VSP Covered California vision plans added earlier in the year. Before families enroll in one of the vision plans they should remember that health insurance through Covered California also includes vision benefits for household members 18 years old and younger.
Covered California branded vision plans
Enrollment into the vision plans is not handled by Covered California. There are external enrollment websites to purchase the vision insurance through either EyeMed or VSP. However, the vision plans have been approved by Covered California and differ from vision plans from both companies offered outside of the exchange.
Comparing EyeMed to VSP vision insurance
The most striking difference between EyeMed and VSP is that EyeMed offers three different Covered California plans and VSP only offers one. This adds more consumer choice as opposed to a one-size-fits-all approach. One annoying aspect of the EyeMed quoting and enrollment website is that you have to register before you get a quote. This triggers an email with no identifying logos about creating a customer login account, which will most likely be dumped into the consumer’s spam folder of their email application.
While comparing vision plans should be easy compared to health insurance, the coverage outlines for the plans don’t always use the same terms. There are are also confusing discounts applied to amounts over the allowed amount. Consequently, the consumer doesn’t know if they are comparing apples to apples or bananas to bifocals.
Covered California VSP to EyeMed Vision Plan Comparison
|Single Vision Lenses||$25||$20||$20|
|Frame Allowance||$120||$200||$130||35% Discount|
|Progressive lenses no-line bifocal||$55 – $175||$20 – $77||$80||$135 – 30% Disc.|
|Transition photochromic||$70 – $82|
|Scratch resistant coating||$0||$0||$12|
|Impact Resistant Lenses||$31|
|California Monthly Premiums**|
*Includes 20% savings on amount over frame allowance. **Rates may vary by region.
Discounts from the retail price
The EyeMed Healthy Plan is the least expensive but also has the greatest risk for the highest out-of-pocket costs. This is because several of the covered benefits (frames and progressive lenses) have percentage discounts off of the retail price as opposed to a set copayment. The question becomes, “What is the retail price?” Is the retail price from the manufacturer, the independent optometrist, or the store where the optometry office is located?
Bold vision plan similar to VSP-120
EyeMed’s Bold Plan seems to be the most comparable to the the VSP-120 Plan. While the monthly premium is a little higher than VSP, the coverage outline indicates that some of the benefits have a lower copayment and the frame allowance is a little better. One specific item missing from the EyeMed plan outline is the Transitions photochromic lens option. The Transitions’ lenses darken when the the lenses are exposed to sunlight. VSP has a sliding scale copayment of $70 to $82. The EyeMed coverage outline indicates that this might be a “Other Add-On and Services” option with a 30% discount from the retail price.
$200 frame allowance
The Bright vision plan from EyeMed has a $200 frame allowance while all the other costs are similar to their Bold plan. The higher frame allowance of the Bright plan is similar to another VSP plan called Easy Option with a $230 frame allowance. The EyeMed Bright plan is comparably price to the VSP Easy Option which is not offered through the Covered California option.
EyeMed participating optometrists
EyeMed seems to have decent number of optometrists including independents and retail outlets located in large stores such as Target and JC Penney.
EyeMed Provider Search Page
You can also search for providers that offer same day service, sport and safety glasses, or designer frames such as Burberry, Disney, or Versace. (I didn’t even know Disney made eyeglass frames.)
Do you see value in vision insurance?
EyeMed seems comparable to VSP in terms of the plans offered either under the Covered California banner or from individual and family plans not associated with the exchange. The vision insurance companies have thoroughly researched the market for eyeglasses and contact lenses and know the costs. If one plan is slight more or a little less in monthly premium, there is more than likely corresponding benefits that have the member either shouldering more of the out-of-pocket costs or provide a favorable set copayment to the consumer.
Both EyeMed and VSP have either a monthly premium or one-time annual payment. Enrollment in the plans is open year round. This means if you don’t like the vision plan you have chosen, you can switch. Similar to VSP, you can visit an out-of-network optometrist and get some reimbursement for your expenses. EyeMed outline of coverage document below lists the reimbursement rates.
Get a quote on Covered California EyeMed plans
|Date:||June 3, 2016|