LISTEN LIVE

Some Ditching Vision Insurance, Paying Less Out Of Pocket

Nov 30, 2017

Musician Dave Eichenberger is on his computer at his New Port Richey studio uploading a headshot to Goggle4U's website so he can virtually try on a pair of fuchsia eyeglasses.

"Aw, I'm sideways, but we can fix that,” he says, squinting at the screen. “What I'm going to do is I'm going rotate my head sort of like that, and then we have to scale this.”

He clicks on the sizing tool.

“Ohhhh, ok,” he says as the plastic framed glasses adjust to his digitized face.

According to the American Academy of Ophthalmology (AAO), Eichenberger is one of more than 150 million Americans who use corrective eyewear to compensate for vision issues not related to disease.

The AAO says that in the United States, people spend more than $15 billion each year on eyewear. Eichenberger feels a lot of that is expensive eyeglasses - and insurance premiums that aren't worth paying.

"What I found was that it is really not serving a lot of people out there. It certainly didn't serve me,” he said.

Just over eight percent of Americans with vision problems do not have vision insurance, according to the Centers for Disease Control and Prevention. And half of those who have the option to buy vision insurance, don't.

One big reason is because vision and dental coverage are not part of most health care plans, so people have the option not to purchase them.

For example, Eichenberger pays for a supplemental dental plan through the American Society of Composers, Authors and Publishers. But vision  coverage is not offered, and he said he knows he couldn’t afford it anyway.

So he found a local optometrist willing to do the exam for $50, and purchases his progressive bifocals online, spending less than $200 altogether.

“The money that I would have to spend on vision insurance so far exceeded what I just spent out of my pocket on glasses, on an exam," Eichenberger said.

Tibor Laczay is the CEO of Zenni Optical - an online retailer similar to Goggles4U. Laczay said that because the company owns its own manufacturer and online store, they can offer glasses for a fraction of the price most brick-and-mortar retailers sell them for.

Sometimes that’s as low as $10 a pair, which includes lenses, he said. Customers do, however, need to get a valid prescription from an eye doctor before they can place an order.

Laczay said even people with vision insurance pay enormously high rates for their frames at some retailers. It’s not uncommon to pay $200 or more out of pocket, just for the frames, after the insurance dishes out their share.

“They get talked into buying a pair of glasses because that's where the optometrists actually make their money and they're not ripping off the public,” Laczay said. “They're just trying survive.”

To cover your overhead, you have to mark up each eyeglass, even if you get it for (free), by $100 or $130 just to break even. So the price structure built into that industry, the way it operates, basically creates these high prices,” he said.

And most insurance companies offering vision plans do not cover the cost of both eyeglasses and contacts. Consumers have to decide what to get under the plan, and what to pay out-of-pocket for.  

Those one-stop shops you see in malls and shopping centers, such as Lenscrafters or Visionworks also see patients who don’t have insurance, but they rarely offer the new discount plans popping up at places like Zenni Optical and some other retailers.

Marina Berry is a young tattoo artist in Tampa. She has astigmatism, a curvature imperfection that one in three Americans have - and it can make eyeglasses really expensive.

"Pay out of pocket, it'll be around $50 for an eye exam,” Berry said. “But it's the lenses that'll be the issue, getting them made for you. Especially if you have such a special condition as I do."

She got her exam done at Optical Outlets, one of the stores that's offering special exam and eyeglass bundles. She said her astigmatism still pushed the price up past the advertised $90 to $250, but she said that's still a lot less than paying monthly premiums and all the special lens upgrades and protections that insurance doesn't typically cover.

"It just doesn't seem really worth it to get the insurance,” Berry said. “There's Optical Outlets everywhere, there's Walmarts everywhere."

Credit Daylina Miller / WUSF News

Kyle Barnett, a district manager in Florida for discount optical retailer America's Best, touts his company's $69.95 special, which includes an eye exam and two pairs of glasses. While the pricing changes depending on a patient's needs, he said they're transparent about every fee:

"We definitely want to reach out to those that don't have the managed care piece or the vision insurance and also for those that are looking for just a great deal," Barnett said.

Barnett said one of the biggest advantages to their deals is that, like vision insurance, it encourages people to come back for regular check-ups.

"People are more prone to come back in, and (it increases) the frequency of the exams in our local area,” Barnett said. “And they help fight all those ocular diseases by finding them early."

Credit Daylina Miller / WUSF News

Musician Dave Eichenberger said he knows it's dangerous to wait too long between exams. He's diabetic, and has a higher risk of eye damage - called "Retinopathy."

"By the time you notice vision problems things have gone horribly wrong already,” Eichenberger said. “So you don't want it to get to that. You want to go to the eye doctor all the time."

He said because he's not limited by monthly premiums, and insurance requirements that often only cover exams and glasses every couple years, he can afford to go at least once a year.