What to Know About Vision Insurance Copays
If your child needs dental or eye care Eye exam $30 co-pay/ visit 50% co-insurance Coverage is limited to one refractive eye exam per member per year for in-network and out-of-network services combined for members 18 years of age and younger. Glasses 40% co-insurance 50% co-insurance. For individuals without insurance, the average cost of an eye exam depends on the eye test, location and the type of eye doctor you choose to visit in your area. Combining national averages from FAIR Health and VSP, you can expect to pay: $171-$200 is the average cost of an eye exam without insurance (first visit) $128 for recurring patient visits.
You’ve likely encountered copays when using health insurance to visit a family physician or urgent care facility. Likewise, you’ll have copays when you see an eye doctor and use your vision insurance. Although copays are not new, there are a few common questions people typically ask about their vision plan copays. Here are the things you should know:
What is a copay? Futronic driver.
When you visit an eye doctor, your vision copay is a fixed amount you pay for services.So when you get an eye exam, you pay a copay and your plan covers the rest. Your vision plan identifies what your copay is for vision services.
Why is a copay necessary?
Copays help you manage your budget by knowing ahead of time what you’ll have to pay during your visit.
Are copays the same for all vision insurance plans?
Copays can differ with each plan. You’ll typically find a copay for your exam, one for your glasses, and sometimes copays are associated with specific lens enhancements. That’s why it’s important to review your plan benefits.
What if I have other questions about copays or my plan?
Any time you have questions about your VSP® vision plan copays or your insurance plan in general, you can speak with our knowledgeable customer service team at 800.785.0699. Our service center is open Monday through Friday from 7a.m. to 7p.m. Central Time. We’re happy to do what we can to help you make the most of your VSP vision insurance!
Individual Vision Plan members not only love the benefits of low copays, they’re also happy about the frame coverage and provider network offered through their vision insurance plans. If you'd like to look at plans that are ideal for you and your family, visit our vision plan finder today.
Here’s what VSP Direct members have to say:
“I work on computers every day, so to be able to get a pair of computer glasses and only have to pay the copay is excellent.”
– D. Rimes
“My old insurance didn't cover enough for designer frames. But since I've had VSP, I can choose Gucci or Bebe and not go broke in the process.”
– D. Fletcher
“There was a great selection of providers in our area, including one close to my house.”
– M. Simmons
If you qualify for VA health care benefits, you may be able to get some or all of your vision care through VA. Find out more about our vision care.
Are my routine eye exams covered under my VA health care benefits?
Yes. If you have VA health care benefits, we’ll cover your routine eye exams and preventive vision testing (like testing for glaucoma).
To schedule an eye exam, talk to your VA primary care provider or contact your nearest VA medical center or clinic.
Find a VA medical center near you
If you’re a blind or low vision Veteran, you may be able to get more advanced vision care and rehabilitation services.
Find out if you qualify for blind and low vision Veteran services
Will VA cover the cost of eyeglasses?
We’ll cover the cost of your eyeglasses if you meet at least one of the requirements listed below.
At least one of these must be true. You:
- Have a compensable service-connected disability (a disability linked to your military service for which you’re receiving VA disability payments), or
- Are a former prisoner of war (POW), or
- Were awarded a Purple Heart, or
- Receive benefits under Title 38 United States Code (U.S.C.) 1151, or
- Receive an increased pension based on your being permanently housebound and in need of regular aid and attendance
Or, you must have at least one of these issues:
- Vision problems caused by an illness—or the treatment of an illness—for which you’re receiving VA care, like:
- Stroke
- Diabetes
- Multiple sclerosis
- Vascular disease (diseases that affect your blood vessels)
- Geriatric chronic illnesses (long-lasting illnesses that affect the elderly)
- Vision problems caused by an injury—or the treatment of an injury—for which you’re receiving VA care, like:
- A reaction to prescribed medicines
- Cataract surgery or other surgeries of the eye, ear, or brain
- Traumatic brain injury or polytrauma (injuries to more than 1 body part or organ, often caused by a blast)
- Functional impairment (parts of your body that don’t work as well as they should) or cognitive impairment (a problem with memory or thinking skills) that’s severe enough to make it hard for you to do everyday tasks
- Vision and/or hearing loss (called dual sensory impairment) that’s severe enough to interfere with your ability to take an active role in your own health care—and eyeglasses would help to reduce the impact of your impairment
For more information, contact the prosthetic representative at your nearest VA medical center or clinic.
Find a VA health facility near you
Cigna Eye Exam Copay
If I have vision and hearing loss, will VA cover the cost of hearing aids too?
More information about your benefits
Kaiser Eye Exam Copay
Health care benefits eligibility
Not sure if you qualify? Find out if you can get VA health care benefits.
How to apply for health care benefits
Ready to apply? Get started now.
Health needs and conditions
Find out how to access VA services for mental health, women’s health, and other specific needs.
Disability benefits
Have an illness or injury that was caused—or made worse—by your active-duty service? Find out if you can get disability compensation (monthly payments) from VA.