New insight on how vision insurance affects eye health: study

Dec. 11, 2012, 3:29 p.m.

Eyeglasses. Researchers found that holders of vision insurance saw the eye doctor more and reported better eyesight than people who weren't covered. (ernie. ca/Flickr Creative Commons)

People with vision insurance are more likely to see the eye doctor and report better vision, according to a new study.

Which makes sense.

Research appearing in the Archives of Ophthalmology found that access to vision insurance seems to be an important determinant in whether people receive preventive eye exams and care, which can be the difference between healthy eyes and experiencing vision loss and eye-related diseases like glaucoma, age-related macular degeneration and cataracts.

In the study, respondents who'd had an eye exam within the previous year reported, on average, better vision, thus highlighting "the long-term benefits of vision insurance for preventing eye impairment," wrote the authors.

Access to optometrists – the doctors patients see for routine eye exams – is fairly limited in South Los Angeles, while access to ophthalmologists – the surgical and medical specialists who deal with the anatomy, physiology and diseases of the eye – is much worse. Vision (and dental) insurance are more likely to be part of an employer-provided, private insurance package, which many people in South L.A. don't have.

On top of that, vision insurance, like its dental counterpart, isn't much of a priority for many folks in the safety net.

"I would guess that vision and dental insurance that's privately paid out-of-pocket is not something that's a priority for most people," said Nina Vaccaro, the executive director of the Southside Coalition of Community Health Clinics. "Those are services that, for most of us, we only need once every few years."

The problem, she said, comes when "you have that crisis with your vision or your oral health." That's when those auxiliary forms of insurance come in handy.

But in the interim, most low-income people have more pressing things to think about.

"People probably prioritize paying their rent, paying their car insurance, putting food on the table, getting school supplies for their kids," said Vaccaro. Within the safety net, buying any kind of insurance, she said, "is a luxury."

Vaccaro previously told OnCentral that diabetics in particular need regular access to eye care because their condition puts them at "extra risk for going blind and having vision problems." The need is so great that some southside clinics have turned to telemedicine as a way to diagnose eye patients and connect them with any necessary treatment.

The authors concluded that vision insurance "should be mandatory in all health plans." But that's far from being a reality. For example:

– Vision isn't covered by the county's no-cost health plan, Healthy Way LA.

Medi-Cal, the state's Medicaid program, will pay for tests, but won't cover eyeglasses or contacts for any beneficiaries 21 or older.

Healthy Families is a state-run, low-cost health insurance program for uninsured young people who don't qualify for free Medi-Cal, and it covers eye exams and glasses if they are determined to be "medically necessary."

Medicare doesn't normally cover eyeglasses and eye exams, although some people may have what's called a Medicare Advantage plan or other retirement benefits that help with those services. Besides that, the plan "may cover some vision costs if they are associated with other covered expenses," but the requirements are fairly restrictive. Cataract surgery is covered, as is glaucoma screening for people who are determined to be high-risk.

The difficulty of accessing vision and dental services, explained Vaccaro, is part of the reason people make a beeline for dentists and optometrists at events like the annual Care Harbor Clinic.

Photo by ernie. ca via Flickr Creative Commons.

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