Eye care insurance plans

What is an eye health insurance care plan?

An eye care plan, or optical cover, is a type of health insurance that takes care of most of your eye-related needs:

• It covers all the eye care services you need, including any additional charges, and specifies how much reimbursement you can expect.
• It outlines any deductibles you’ll have to pay before certain services are covered.
• It includes provisions for unforeseen circumstances like force majeure.

It is very important to carefully go through the details because these plans come with a lot of conditions. For instance, you might have to pay a certain amount before the plan starts covering your eye care expenses. Also, there will be specific rules about what services are covered and to what extent they are reimbursed.

Vision care insurance is usually relatively affordable because the costs it covers are predictable, and big claims are rare. Most people just need regular check-ups and minor treatments, so insurers don’t have to pay out large amounts often.

Does health insurance cover my eye health?

Not always. Not all health insurance plans cover vision checks, so it’s important to examine your policy. Optical insurance, which falls under medical insurance, offers different levels of coverage for eye care.

Basically, health insurance plans provide some degree of optical coverage, but you’ll want to read the fine print to understand exactly what’s included.

What does optical insurance cover?

While the specifics vary depending on the provider and the plan, here are the main categories of services included in optical cover:

Glasses and contact lenses

Optical insurance helps cover the cost of prescription eyeglasses and contact lenses, including disposables. This includes the frames, lenses, and any necessary adjustments, and some plans even include prescription sunglasses.

Eye tests

Regular eye exams are essential for maintaining eye health and detecting any vision problems early. Therefore, insurers cover the cost of routine eye exams, including tests for visual acuity and eye health assessments.

In-patient treatment

If you require eye surgery or any other in-patient treatment related to eye conditions, optical insurance sometimes helps cover the expenses associated with hospitalisation, surgery, and follow-up care.

Let’s say a member develops a serious eye condition that requires surgery, such as cataracts or retinal detachment. In this case, their insurance will cover the costs associated with the surgical procedure, hospital stay, anaesthesia, surgeon fees, and any necessary follow-up care during your recovery period.

Out-patient care

Many eye conditions can be treated on an out-patient basis. So, eye insurance often covers the costs of such services as visits to ophthalmologists or optometrists, treatments for eye infections, and management of chronic eye conditions.

For example, a member experiences frequent eye irritation and discomfort due to some reasons. They schedule an appointment with an ophthalmologist. The member’s optical insurance would cover the cost of the doctor’s visit, diagnostic tests, prescribed medications, and any other out-patient treatments needed to manage their eye condition.

How much will I be covered if I include eye care in my health insurance?

If your health insurance plan includes coverage for eye care, you typically get around £200 per year per policyholder. So, if an optometrist identifies an eye problem needing treatment, your standard policy will cover it.

However, if you need constant eye care, such as regular vision checks, surgery, or glasses, it’s better to purchase additional optical cover. It makes sense for some people to have comprehensive coverage tailored specifically to their eye health needs.

Benefits of private eye insurance

If you’re thinking of eye care for yourself and your family members, here’s why it could be a smart move:

Considering these benefits, private eye insurance is really worth considering for your health. Take your time to check out different options and chat with specialists to pick the best one for you. Getting advice from insurance specialists can be very helpful in finding the perfect fit for your needs.

Insurers with eye health insurance cover plans

Now, here are some of the major insurers in the UK that can help you get covered for your eye care needs:

Aviva

With the Aviva’s enhanced option to core cover, you can add extra benefits to your policy each year:

• You can get up to £150 to help cover the cost of glasses and contact lenses if you pay £50 first as excess.
• The basic coverage only includes consultations and treatment with a specialist. Sometimes, you might need to see a general practitioner before visiting an eye doctor, but the benefits will apply when you use both services.
• The optical benefit will cover the cost of new glasses or contact lenses due to a change in your prescription.

Aviva doesn’t pay for eye tests, optical solutions, accessories like cases or cleaning cloths, or contract schemes, such as monthly disposable contact lenses. Also, if you’ve selected optical add-on benefits, they won’t cover:

• Regular medical check-ups, health screenings, or vaccinations
• Treatment meant to prevent illness or disease
• Any treatment aimed at diagnosing a disease or illness if you don’t have symptoms, like genetic tests

Bupa

With Bupa Optical, an optional benefit in Bupa By You, members get:

• No gap packages
• Comprehensive eye examinations
• Discounts on fashion frames of up to £100
• Free digital retinal photography
• Bulk-billed eye tests
• Expert advice on selecting the right frames, lenses, and contacts

In select locations, Bupa Optical carries popular brands like Oakley, Ray Ban, Prada, and more. They also provide various lens options, from custom-made to specialised lenses for sports, children, and safety.

However, take into account that Bupa Optical doesn’t cover treatments for correcting long or short-sightedness, age-related vision deterioration, glasses, contact lenses, or laser-assisted cataract surgery. Exceptions also include coverage for injury or acute conditions, such as a detached retina.

Exeter

Exeter’s cash plan allows you to claim cashback on seven types of treatments, one of which is optical. The amount you can claim depends on the level of cash plan you’ve chosen. The levels are £120/£140/£165/£200/£235/£260/£350 per year.
You can claim reimbursement for various optical treatments up to the plan limits, with a £50 excess. This means the first £50 of treatment costs can’t be claimed back, except for eye tests where no excess applies.

Covered treatments include:

• Eye tests
• Prescribed glasses, contact lenses, including monthly prescribed
• Repairs to or replacement of frames or prescription lenses
• Sunglasses or goggles issued under prescription
• Laser eye treatment (after holding and paying for the plan for a minimum of 2 years)
• Other eye operations to improve eyesight, such as cataracts or astigmatisms

Items and procedures that are not covered:

• Cosmetic eye treatment or operations
• Non-prescription glasses, sunglasses, contact lenses, or goggles
• Charges for anything not directly improving eyesight, like missed appointment fees
• Optical consumables, such as contact lens cases, lens solutions, or other cleaning agents

Please note that if you’ve taken an additional plan for your partner, you’ll need to pay a separate excess for the benefits.

Freedom

At Freedom, eye care is offered in both plans: Essentials and Elite.At Freedom, eye care is offered in both plans: Essentials and Elite.

Under the Essentials plan, members can get a full refund, up to £150, for routine eye tests, prescription glasses, and contact lenses. However, they’ll only cover glasses and contacts if your optician has confirmed you need a new prescription or if your existing prescription has changed.

Freedom also covers treatment for eyesight and vision disorders resulting from acute conditions, such as cataracts or detached retina.

They won’t cover laser eye surgery, optical solutions, accessories like cases and cleaning cloths, or monthly disposable contact lens schemes. Also, the coverage doesn’t extend to treatments to correct common vision issues like short-sightedness, long-sightedness, astigmatism, or other vision disorders caused by factors like ageing or genetics.

Under the Elite plan, you can receive a full refund, up to £200, for routine eye tests, prescription glasses, and contact lenses. All the coverage criteria remain the same as the Essentials plan.

AXA

While there’s no separate insurance for optical needs, there are cash plans. You have two options: the Basic Plan and the Enhanced Plan. Both cover dental and optical expenses, but the Enhanced Plan offers extra benefits.

With regular dentist and optician cashback, you can get up to £25 back for an eye test every year. They will also refund 80% of what you spend on glasses and contacts, up to £200 a year.

With dentist and optician cashback+, you still get up to £25 back for an eye examination each year. But the cover for glasses and contacts goes up to £300 a year. Plus, you can get up to £10,000 a year if you have a dental accident, with up to £2,500 covered per incident, up to four times a year.

There you go — five provider choices for you to consider. They’re all set up in different ways, so you can pick the one that works for you. Best of luck with your decision!