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What is the difference between a vision plan and a medical insurance?

This is a very common question especially during open enrollment.

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Strictly speaking, vision plans are not real "insurance." Rather they are similar to "prepaid" plans where they are primarily funded through regular payroll deductions. Your vision plan often covers routine exams, contact lens evaluation, and some eyewear or contact lens materials (subject to additional copays and out of pocket expenses). Vision plans often function as the "middle man" that assume little financial risk, if any, but helps connect patients with eye doctors.

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Medical insurance provides substantial services and assumes risk in the event of an accident, injury, or illness. As it pertains to eye care, they cover management of medical eye conditions and at times even cover "routine" eye examinations (subject to copays, deductibles, and coinsurances). Though exceptions do exist, most medical insurances do not cover for contact lens evaluation nor eyewear/ contact lens materials due to their cosmetic nature.

What is the difference between a vision plan and a medical insurance?: FAQ

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