Does Obamacare Cover Vision?

The goal of the Affordable Care Act, which was put into law in 2010 by President Obama (hence the informal name ‘Obamacare’) was to make health insurance more widely available and more affordable for Americans. While the ACA had the best intentions, it also made coverage more confusing than it already was.

If you are already covered by Obamacare or you are thinking about switching because your employer doesn’t offer health insurance benefits or because you can’t afford the cost on your own, you’re probably wondering what is covered. More specifically, if you are in need of corrective lenses, you likely want to know if the Affordable Care Act will cover your vision. Read on to learn more about Obamacare and vision coverage.

Vision Coverage Under Obamacare

Under the Affordable Care Act, health insurance providers are required to offer vision coverage for individuals who are 19 years of age or younger; in other words, pediatric vision is considered an essential health benefit under Obamacare. As such, anyone who is 19 or under receives vision coverage through an individual market plan, and that applies to plans that are secured both on and off the Exchange. Therefore, if you have children and you have Obamacare, their eye care will be covered, including exams, screenings, and corrective lenses (both glasses and contact lenses). However, if you are older than 19, you might not be covered.

Vision Coverage for Adults under Obamacare

While pediatric vision care is mandated under the Affordable Care Act, for adults, it isn’t. Health insurance providers that offer coverage through the Marketplace can choose whether or not they include vision coverage for adults, so if you are over the age of 19, your vision care may not be covered.

Some Obamacare health insurance plans do offer vision; however, there are stipulations. For example, the amount of coverage that a plan offers may be limited, which means that you may have to pay out of pocket expenses for screenings or corrective lenses, even if you do have coverage.

If you are considering enrolling for health insurance through Obamacare, it’s important that you take the time to find out exactly what your policy will cover before you sign up. Often times, people are dismayed when they learn that their coverage does not include vision care, which is understandable. To avoid any mishaps or unexpected expenses, make sure that you read through and understand all of the details that pertain to the coverage you are considering. You can find out about different options and the rules that apply to policies by visiting healthcare.gov. Here, you will find pertinent details relating to Marketplace plans available in your state.

What Happens if Your Plan doesn’t Include Vision?

If the plan you are considering doesn’t include vision care and this type of coverage is important to you, you can purchase stand-alone adult vision coverage. However, do note that these types of plans are not offered through the Marketplace; furthermore, the use of premium subsidies to offset the cost of stand-alone vision coverage is not allowed.

Should your Obamacare insurance plan not provide vision coverage, you might want to consider finding out if your employer offers health insurance, and if so, whether or not vision coverage is included. If your employer does not offer health insurance, or if it does and vision isn’t included, again, you can invest in a stand-alone vision care plan; however, the cost may not be worth your while. The cost of vision insurance can be exorbitant; therefore, unless it is something that you absolutely need, it may not be worth the investment.

Finding Affordable Vision Insurance

For many American adults, vision insurance coverage is important; particularly for those who already have vision trouble and need corrective lenses or Lasik surgery. However, it’s also important adults who do not need glasses to have their eyes examined annually. As you age, your eye health and vision can deteriorate. Not only do the chance of poor eyesight increase as you age, but so does the risk of cataracts, glaucoma, macular degeneration, and various other eye-related diseases.

If you do not have vision coverage, the cost of screenings, glasses, contacts, and other procedures can be quite costly; however, purchasing a stand-alone vision policy can also be expensive. That doesn’t mean that you have to leave the health of your eyes at risk – or go broke trying maintaining your vision care; there are affordable insurance plans available that can either completely cover the costs of vision-related care or that can help to offset the costs. For example, depending on the vision plan you choose, your insurance provider may cover a certain percentage of vision screenings, glasses, and contact lenses.

To find out more about the different types of vision insurance plans and the options that are available to you, speak to a reputable insurance agent as soon as possible.