Glasses and Contacts: How to Maximize Your Vision Insurance

Vision insurance can save you money on eye exams, glasses, and contact lenses, but many people leave benefits on the table because they do not fully understand how their plan works. With the cost of eye care rising, averaging about 4.3% higher in 2024 according to the Bureau of Labor Statistics, it pays to know how to get the most out of your vision coverage.

This guide explains how vision insurance benefits work, how to maximize your coverage for glasses and contacts, and when it may make sense to pay out of pocket instead. Whether you have a standalone vision plan, a Medicare Advantage plan with vision benefits, or employer-sponsored coverage, these strategies can help you save.

Understanding Your Vision Insurance Benefits

Most vision insurance plans cover a standard set of services, though the specifics vary by plan. Before you visit the eye doctor or shop for new glasses, take time to understand what your plan includes.

Typical vision plan benefits include:

• Eye exam: Most plans cover one comprehensive eye exam per year with a small copay, typically $10 to $25. The exam includes a check of your prescription and a screening for eye diseases.
• Frame allowance: Plans provide a dollar amount, usually $100 to $300, toward the purchase of frames from an in-network provider. You pay the difference if you choose more expensive frames.
• Lens coverage: Standard single-vision, bifocal, or trifocal lenses are usually covered with a copay. Progressive lenses may cost extra.
• Contact lens benefit: Most plans offer either a contact lens fitting plus an allowance for lenses, or coverage of medically necessary contacts. Allowances typically range from $100 to $200.
• Lens add-ons: Upgrades like anti-reflective coating, photochromic lenses, and blue light filtering may be discounted but usually come with an additional fee.

In-Network vs. Out-of-Network Savings

One of the most important factors in maximizing your vision insurance is staying in-network. Vision plans negotiate discounted rates with in-network providers, which means you pay less for exams, frames, and lenses when you visit a participating provider.

Here is how in-network and out-of-network benefits typically compare:

• Eye exam: $10 to $25 copay in-network vs. $30 to $50 reimbursement out-of-network (you pay the rest).
• Frames: Full allowance of $100 to $300 in-network vs. a lower reimbursement of $50 to $100 out-of-network.
• Lenses: Covered with a copay in-network vs. a fixed reimbursement amount out-of-network that may not cover the full cost.

The savings difference can be substantial. Before scheduling an appointment, check your plan's provider directory to find in-network eye doctors and optical shops near you.

How to Get the Best Deal on Frames

Frames are one of the biggest costs when buying glasses. With the average frame allowance covering $100 to $300 and popular designer frames costing $200 to $500 or more, you may still face a significant out-of-pocket expense. Here are ways to minimize that cost:

• Choose frames within your allowance: Ask the optical shop to show you frames that fall within your plan's allowance. Many locations have a selection of quality frames at various price points.
• Look for plan-specific promotions: Some vision plans offer bonus allowances or discounts at certain retailers. Check your plan's website for current promotions.
• Consider warehouse clubs: Some vision plans work with warehouse club optical departments, which often have lower prices on both frames and lenses.
• Ask about previous season frames: Optical shops sometimes discount frames from previous collections. These frames are the same quality but may be older styles.

Making Smart Choices on Lens Upgrades

Lens add-ons can quickly increase the cost of your glasses. Understanding which upgrades are worth the money and which you can skip helps you make a better decision.

• Anti-reflective coating ($50 to $150): Reduces glare from screens and headlights. Generally worth the cost if you drive at night or spend long hours on a computer.
• Progressive lenses ($100 to $300): Combine distance, intermediate, and near vision in one lens without visible lines. Standard progressives are more affordable, and premium versions offer wider viewing areas.
• Photochromic lenses ($80 to $200): Darken automatically in sunlight. Convenient if you do not want to switch between regular glasses and prescription sunglasses.
• Blue light filtering ($20 to $70): Some people find this coating reduces eye strain from screens, though research on its effectiveness is mixed. It is a lower-cost add-on if you want to try it.

Check whether your vision plan covers any of these upgrades at a discounted rate. Some plans include anti-reflective coating or standard progressives in the basic lens benefit.

Maximizing Your Contact Lens Benefits

Contact lenses can cost $200 to $500 per year or more depending on the type and brand. Vision insurance helps reduce this cost, but the way contact lens benefits work is different from glasses benefits.

Here is how to get the most from your contact lens benefit:

• Know your allowance: Most plans offer a contact lens allowance, typically $100 to $200. This can be applied toward a year's supply from an in-network provider.
• Ask about rebates: Contact lens manufacturers often offer rebates when you purchase a year's supply. Combining a manufacturer rebate with your insurance allowance can significantly reduce your cost.
• Compare in-network and online prices: Online retailers may offer lower per-box prices than your eye doctor's office. However, your insurance allowance may only apply to in-network purchases. Compare the total cost both ways.
• Consider the contact lens fitting fee: A contact lens fitting is a separate service from a standard eye exam and usually costs $50 to $100. Some plans cover this fee, while others do not. Ask before your appointment.

Timing Your Purchases to Avoid Wasting Benefits

Vision benefits reset at the start of each benefit period, which may be a calendar year or a plan year. If you do not use your benefits before the period ends, you lose them. Unlike an HSA, unused vision insurance benefits do not roll over.

Smart timing strategies include:

• Schedule your eye exam early in the benefit year: If your prescription changes, you will have the rest of the year to use your glasses or contact lens benefit.
• Do not let benefits expire: If it is late in the benefit year and you have not used your glasses benefit, schedule an appointment. Even if your prescription has not changed, you can use the benefit for a backup pair.
• Straddle benefit years for major purchases: If you need both glasses and contacts, use your glasses benefit at the end of one benefit year and your contact lens benefit at the start of the next.

Stacking Vision Insurance with HSA or FSA Funds

One of the most effective strategies for reducing your vision costs is combining your vision insurance benefits with a Health Savings Account (HSA) or Flexible Spending Account (FSA). You use your vision insurance to cover part of the cost and then pay the remaining out-of-pocket expenses with pre-tax HSA or FSA dollars. For a complete overview of eligible expenses, see our guide on using your HSA or FSA for dental and vision expenses.

Here is an example of how stacking works:

• Frame cost: $250
• Vision insurance frame allowance: $150
• Progressive lenses with anti-reflective coating: $200 (after insurance covers standard lenses)
• Your out-of-pocket cost: $300 ($100 for frames + $200 for lens upgrades)
• Paid with FSA (22% tax bracket): You save approximately $66 in taxes by paying with pre-tax FSA dollars

By stacking your vision insurance with your FSA, you effectively reduce the $450 purchase to about $234 in after-tax dollars. The savings are even greater if you are in a higher tax bracket.

When to Use Insurance vs. Pay Cash

There are situations where paying cash, especially through an online retailer, may actually cost you less than using your vision insurance. This is most likely when you want basic, single-vision glasses without expensive upgrades.

Online prescription glasses retailers often sell basic frames with single-vision lenses for $30 to $200, including anti-reflective coating. If your vision insurance copay for lenses plus the out-of-pocket frame cost exceeds what you would pay online, it may make sense to skip the insurance for that purchase and save your benefit for when you need it more, such as for progressive lenses or a premium pair.

However, use your insurance benefit when:

• You need complex lenses like progressives, high-index, or specialty lenses
• You want premium frames that would cost significantly more without the allowance
• Your benefit period is about to end and you would otherwise lose the benefit
• You need a contact lens fitting, which is a service not available online

The Bottom Line

Getting the most from your vision insurance comes down to understanding your benefits, staying in-network, and timing your purchases wisely. Know your frame allowance, compare lens upgrade costs, and use your HSA or FSA funds to cover what insurance does not.

For a broader look at whether vision coverage makes sense for your situation, read our article on whether vision insurance is worth it. Remember that eye care costs continue to rise, so having a plan to manage those expenses can make a meaningful difference in your budget.

Plans and coverage vary by provider and location. This article is for educational purposes and does not constitute individual financial or insurance advice. Check your specific plan documents for details on your coverage.