Ophthalmology insurance is offered by some insurers and is usually included in health insurance. But do you know exactly what coverage you can count on when subscribing to this type of product? To mark World Sight Day, celebrated on October 8, we explain what ophthalmology insurance consists of and what coverages may be included.
According to the world’s first study on vision difficulties and impairments by the World Health Organization (WHO) in 2019, at least 2.2 billion people have vision problems or blindness. More than one billion cases could have been prevented or still lack diagnosis.
In this sense, it is increasingly vital that you pay attention to yourself, so it is essential to ensure that your health insurance includes ophthalmology coverage.
By taking out health insurance, you can access a series of hospitals and doctors specializing in private health, according to the network agreed with your insurer, including the specialty of ophthalmology.
In this way, you will access health care more quickly, thus avoiding waiting for a consultation that sometimes characterizes public health services.
What is health insurance?
Health insurance is a contract between the insurer and the insured, allowing you to access a series of benefits in terms of access to health care. In this way, when you need to visit a doctor, when using your health insurance, you pay a much lower amount for the consultation, examination, or hospitalization (depending on the insurance you take out).
Like other insurances, health insurance works as a safeguard for exceptional situations, avoiding surprises that could mean a solid financial shock.
To have access to discounts and benefits related to health care, you must pay a premium, as a monthly rule, which is stipulated in your contract and is defined according to the type of plan and coverage you choose.
What coverage does eye care insurance include?
Health insurance is not all the same, and the coverage they offer depends on the insurer and the type of plan you choose.
To be entitled to ophthalmology insurance, you must guarantee two situations in your policy :
- That outpatient coverage ensures expenses with ophthalmology specialty consultations, auxiliary diagnostic exams, and outpatient treatments and also guarantees hospital care on an external basis, for example, with costs with minor surgeries without hospitalization;
- This includes coverage for prostheses and orthotics, which cover the costs of eyeglasses and prescription contact lenses.
As a rule, even in the most basic plans, insurers offer quite an extensive outpatient coverage, providing general medicine consultations and several other specialties, depending on the agreed network, which also includes ophthalmology consultations.
However, not all health insurance options include coverage for prostheses and orthoses, which can be an asset for those who have vision problems and need to change glasses or lens graduations with some regularity since it covers the costs associated with this type of expense.
When contracting health insurance that provides ophthalmology services, as a rule, you will have access to:
- Ophthalmology consultations with doctors from the network agreed with your insurance company;
- Access to optical networks, with a discount on the purchase of frames and lenses, depending on your insurance company’s agreements.
If you are not satisfied with your health insurance contract and feel that you need something more complete, namely that which includes ophthalmology insurance, be sure to ask for other proposals to choose the insurance that best meets your specific needs.
What to watch out for when taking out eye health insurance?
When taking out health insurance, you should consider the premium you will pay. In a simplified way, this refers to the monthly cost you have for subscribing to this service.
Although in health insurance, this premium is usually paid monthly, in some cases, it may be quarterly, half-yearly, or annually, according to what you have agreed with your insurer.
It should also be noted that the premium is variable; that is, several conditions can affect it, making it cheaper or more expensive. In particular, among these factors are age, clinical history, lifestyle, among others.
When you buy health insurance, you are presented with a policy containing the contractual conditions defined by the insurer. You must analyze, in detail, the coverage included and whether they correspond to your needs and what has been said. With the insurer a priori.
How to choose the best health insurance?
Choosing the best health insurance will have to analyze your needs and the type of benefits you prioritize. The answer to which the best health insurance on the market is, therefore, involves comparing and analyzing the various entities’ offers to understand which offers the best conditions for your particular needs.