Financial Answer Center
- The New Health Care Law and its Effects
- Why You Can't Be without It
- Employer Plans
- Coordinating Employee Benefits with Your Spouse
- Traditional Group (Indemnity) Plans
- Preferred Provider Organizations (PPOs) / Point-of-Service (POS) Plans
- Health Maintenance Organizations (HMOs)
- Consumer-Driven Health Care (CDHC) Plans
- Paying for Medical Coverage
- Making the Right Choice
- Terminating Employment and COBRA Coverage
- Dental Plans
- Vision and Hearing Plans
- Health Care Flexible Spending Accounts
- Health Savings Accounts
Do you go for an eye exam annually? Do you like to get new frames every year? Vision plans can be a toss-up, simply because your benefits are limited. For example, most plans won't pay a benefit towards a new pair of frames unless the prescription for your lenses has changed. They typically don't cover replacement of broken, lost or stolen lenses, or frames. And they typically will only pay a benefit in a plan year for either frames and lenses or contacts, but not both. You need to estimate the cost/benefit of enrolling in an employer plan, on a year-to-year basis.
Let's look at a sample benefits illustration:
Say you're planning to get an annual eye exam, a new pair of frames, and new lenses in the coming year.
|
Service |
Cost |
Benefit |
Net Expense |
|
Eye exam |
$ 75 |
$ 55 |
$ 20 |
|
Single vision lenses |
$ 45 |
$ 36 |
$ 9 |
|
Frames |
$100 |
$ 50 |
$ 50 |
|
Total |
$220 |
$141 |
$ 79 |
|
Annual premium |
N/A |
N/A |
$ 34 |
|
Your Total Cost |
$220 |
$141 |
$113 |
In this example, the total charge for the eye exam, lenses and frames is $220. If you subtract the benefits paid from the charges ($220 minus $141), your net expense is $79. Add the cost of the annual premium and your total cost is $113. You save $107 ($220 minus $113). Enrolling in the vision plan for the coming year is worth the cost.
