One of the secondary benefits of the Affordable Care Act is the new plan offerings in the individual market. Both VSP and Blue Shield of California have introduced individual and family vision insurance plans (IFP) with benefits rivaling group plans. Just as we have seen the medical benefits for IFP become equivalent to small group plans, the insurers are reworking their dental and vision insurance products to be more comprehensive as well.
Better individual vision insurance plans
Dental and vision plans that had both low premiums and good benefits have always been the domain of the group market. The group market offered a stability of membership that the tumultuous individual and family market lacked. Consequently, the ancillary insurance plans such as dental and vision, if offered at all, have been thin on benefits relative to the monthly premium. This trend is starting to change.
Vision Service Plan for families
VSP of Rancho Cordova has introduced WellVision, an individual vision plan that will be administered by Careington BenefitSolutions. VSP has had a strong presence in the group market for years and is known for excellent customer service to both the members and providers. They are leveraging their large network of optical providers to expand into the individual market. The big unknown is if the customer service will remain the same.
Blue Shield vision test
Blue Shield of California announced a stand alone vision plan early in 2013 but they have done little to promote it. A couple years ago Blue Shield came out with a combo dental and vision plan called “Specialty Duo”. Their new Ultimate vision plan, administered by MESVision, (Blue Shield of California Vision) has better benefits than the Specialty Duo and a higher price. Ultimate vision is only being offered to people who are applying for Blue Shield health insurance. That doesn’t mean you must have a Blue Shield health plan. They may start marketing it as its own product later.
Rates still higher than group plans
The monthly premiums are similar for the two plans, but Blue Shield doesn’t offer a family rate like VSP.
| Monthly Premiums California | Single | 2 People | Family |
| WellVision | $20.33 | $39.66 | $54.75 |
| Ultimate Vision | $21.00 | $42.00 | 3 Child Maximum |
In-network Optometrists are important
The benefits seem to favor Blue Shield, but price isn’t always the final arbiter. There is also the quality of material and customer services to be considered. There also seems to be an underlying tone in the Blue Shield literature to send people people on the path to a big box retail store or online frame and lens company. The Ultimate vision plan does provide some coverage for out-of-network providers making the Blue Shield plan a little more flexible in regions with few in-network providers. There was no indication in the VSP literature that they would cover any out-of-network costs.
| VSP | Blue Shield | |
| WellVision | Ultimate Vision | |
| Annual Eye Exam | $15 | $15 |
| Annual Lenses/Frames | $25 | $25 |
| Contact Lenses | $0 | $25 |
| Copayment | Allowance | |
| Progressive Lenses | $55.00 | $140 |
| Anti-Reflective | $41 – $85 | $50 |
| Photochromic Transition | $70 – $82 | $200 |
| Frame ($150 allowance) | $150.00 | $150 |
| Contact Lenses Allowance | $150.00 | $150 |
Good vision insurance getting better
All the insurance companies from dental, vision to medical insurance have been updating products and services to capture a larger portion of the new market being developed because of the Affordable Care Act. As long as these companies are offering “real” insurance and not just useless “discount” programs, families will benefit in the long run.