What to do if your vision insurance doesn't fully cover contacts

You picked your plan, paid your premiums and made your eye appointment. Now that it's time to stock up on lenses, you discover that your vision insurance won't cover contacts or only covers part of the cost. Cue confusion and a scramble to check your bank account — along with frustration that you're caught in this situation.

Unfortunately, this scenario plays out regularly, with contact lens wearers footing more of the bill for vision correction than they planned. While you might have foresight into this outcome, you don't have to panic. There are ways to get the lenses you need without blowing your whole budget.

This guide walks you through what to do if you have insurance but it doesn't cover contacts fully or you don't have vision insurance at all:

If you have insurance and it won't cover contacts or only partly covers them, we'll talk about:

• Verifying what's covered

• Investigating other plan options

• Combining insurance benefits and rebates

If you don't have insurance, we'll talk about:

• Seeing how your eye doctor can help

• Consulting a SHIP

• Investing in a full year of contacts up front to save money

• Evaluating less expensive options

• Avoiding reusing contacts just to save money 

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Step 1: Understand what you want and need

Before you dive into coverage details or start the hunt for stellar deals, take a moment to clarify what you actually need. Are you looking for the most affordable daily lenses? A specialty brand for astigmatism? The convenience of monthlies?

Knowing your must-haves and personal preferences helps you align your search with actual needs and spot the best rebates for you — which might not be the best for everyone else. Setting these types of boundaries can also reduce the time you spend on contact lens research and cut down on frustrations in chasing down deals that aren't even relevant. 

It’s also worth noting that some plans require you to choose between contacts or glasses, so you may need to determine which is most cost effective to use your coverage for.

Evaluate if insurance is the best route

Insurance isn't always the save-the-day hero when it comes to contact lenses. Some plans only offer partial contact lens coverage, and others don't cover contacts at all. They might classify them as "cosmetic" and choose to only cover glasses.

If you already have insurance, start by checking your current coverage. We'll walk you through that in the next section. If you don't have vision insurance, don't rush out and buy the first plan you see. Evaluate what it offers and consider all your options. Back-of-the-napkin math can help you see whether you're better off paying premiums or just paying for lenses yourself.

Verify what’s covered

If you have vision insurance, confirm exactly what's covered and how. Contact your provider's customer service or benefits line or review your plan documents. Pay attention to language, such as discounts versus allowances:

• Discount: A reduced price for contacts or glasses, but you will still pay something 

• Allowance: The amount your plan contributes — you won't pay if you stay under that 

Some plans may cover one eye exam and either glasses or contacts per year but not both. Others might only cover certain brands or types of lenses. Knowing what’s eligible can help you avoid surprise bills or uncovered purchases.

Investigate other plan options (with better coverage for what you need)

If your current plan doesn't cover the contacts you want — or doesn't cover them at all — it might be time to shop around. During open enrollment, look at other insurance options that are more contact-lens friendly.

Plans that include higher allowances for elective lenses or let you use benefits toward both glasses and contacts (rather than forcing a choice) could be a better match. 

See about combining insurance benefits and rebates

Even if your vision plan doesn’t fully cover contacts, you might save money by stacking coverage with available rebates. Some manufacturers and retailers offer money-back deals when you buy a year’s supply or try a specific brand, for instance. Explore coupons for contacts to help lower your out-of-pocket costs.

Step 2: See how your eye care professional can help

The concept of insurance is ingrained enough that some people don't even call for an eye appointment without it. But here's the not-so-secret truth about vision health services: You don't need insurance or some sort of convoluted referral process to access them!

In fact, your eye care team might be able to help you save money. Don't be shy about laying your cards — or lack of insurance cards — on the table. Your vision care provider may know about programs and rebates to help you save money, and if you have insurance that's stubborn about paying claims, they can help you argue for medical necessity.

Whether you're visiting an office in person, ordering through a website, or speaking with billing staff, it never hurts to ask how they can help make vision care more affordable for you.

Step 3: Consider investing in a full year up front

Insurance companies have to watch bottom lines and make for-profit decisions, which can leave contact lens wearers holding the bag for large out-of-pocket costs. One reason for this is that insurance companies may only pay as much for contact lenses each year as they would cover for a pair of glasses. That could mean only a few months of contact lenses.

If you know this is the case, you might consider buying a full year of contacts at one time. Bulk buying is a known tactic for saving money, but what works at Sam's and Costco might also work with a contact lens retailer or vision care office. That's because many manufacturers offer rebates — sometimes several hundred dollars' worth — if you buy all your contacts for a year at one time.

Step 4: Evaluate less expensive options

Glasses are often the cheaper option when you're counting your out-of-pocket costs. Insurance companies look at the fact that glasses can work just as well as contacts for correcting vision, so they might consider contacts as a luxury or cosmetic item and not cover them.

If this is the case for you, you can offset costs by switching between glasses and contacts. Get glasses under your vision coverage for wearing while lounging at home or working in an office. Invest in contacts for playing sports or going out on the town — or switch off in a way that works best for your lifestyle.

Switching between glasses and contacts helps rest your eyes and can reduce how many contacts you need to purchase over the course of the year. 

Step 5: Consult a SHIP

A SHIP (State Health Insurance Assistance Program) offers free, unbiased guidance on Medicare and other health-related benefits, including vision care for eligible individuals.

Even if you're not on Medicare yourself, SHIP counselors can help you navigate complex benefits scenarios, identify low-cost insurance options and assist with applying for supplemental programs. They’re especially useful if you’re helping an older family member with their vision needs or managing multiple health plans.

Step 6: Avoid reusing contacts to save money

Less is not more when it comes to contacts. While there are plenty of ways to fit contacts into your budget, reusing contacts designed as daily disposables or wearing your weeklies for a whole month are not ways to go. In fact, being miserly with contacts in this way can lead to infections and complications that drive up your vision care expenses rather than lower them.

Know how long you can safely wear contacts and stick to best practices. Instead of going rogue with your wearing schedule, talk to your eye care professional about budget-friendly options that may be right for you.

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Learn how to order contact lenses online at 1-800 Contacts
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If your vision insurance won’t cover contacts

If your vision insurance won’t cover contacts, don’t give up — there are still plenty of safe, affordable options. From manufacturer rebates and SHIP programs to advice from your eye care provider, help is out there.

The most important step is understanding what you need so you can find a cost-effective way to get it. And remember: Saving a few bucks isn’t worth risking your health. Always use contacts as directed to avoid infections or complications that could cost you more in the long run.

Did you know you can order contacts online? 

Say goodbye to trips to the eye doctor and hello to convenience! With 1-800 Contacts, you can easily order your contact lenses online and have them delivered straight to your door. Plus, our online vision exam makes it simple to get the prescription you need without leaving home. And the best part? You’ll save money on your first order with 1-800 Contacts. It’s never been easier to get your contacts!