You will be connected with a licensed insurance agent. Call 888.855.6837

Does my health insurance cover vision care?

Major medical health plans will generally cover eye diseases such as glaucoma, cataracts, and macular degeneration, with the same cost-sharing that applies to any other illness. But most health plans do not include coverage for routine vision care such as eye exams, glasses, or contacts.

If you have individual/family or small-group health coverage that took effect in 2014 or later, the coverage will include routine vision care for children. (In most cases, the coverage includes one eye exam and one set of glasses per year.) This is because pediatric vision care is an essential health benefit under the ACA[0]. (Large-group plans are not subject to essential health benefit rules.) Adult vision coverage is not considered an essential benefit under the ACA, so although some major medical health plans do include routine vision care for adults, this is not required and often not included.

Does my health insurance cover vision care?

Major medical health plans will generally cover eye diseases such as glaucoma, cataracts, and macular degeneration, with the same cost-sharing that applies to any other illness. But most health plans do not include coverage for routine vision care such as eye exams, glasses, or contacts.

If you have individual/family or small-group health coverage that took effect in 2014 or later, the coverage will include routine vision care for children. (In most cases, the coverage includes one eye exam and one set of glasses per year.) This is because pediatric vision care is an essential health benefit under the ACA[1]. (Large-group plans are not subject to essential health benefit rules.) Adult vision coverage is not considered an essential benefit under the ACA, so although some major medical health plans do include routine vision care for adults, this is not required and often not included.

Have Questions? Speak to an Agent

Speak to a licensed health insurance agent during business hours for help understanding your options and enrolling in coverage.