Does Insurance Cover Contacts? 

Contact lenses can be a great vision correction option if you’re unable to wear glasses, don’t qualify for corrective surgeries, or would prefer contacts over either of the previous options. In fact, according to the Centers for Disease Control and Prevention (CDC), around 45 million Americans wear contact lenses.¹ If you’re one of the millions who rely on them for clearer vision, understanding the ins and outs of insurance coverage can help you figure out how to get them for a cheaper price and how often you can get them covered.

Does vision insurance cover contacts?

Vision insurance varies, but most plans include some form of coverage for contact lenses, such as:

• Contact lens allowance: Some plans offer a set annual amount for contact lenses. Allowances vary by provider and plan, but a common amount is $150 for a basic plan. However, plans with more comprehensive coverage and higher premiums may offer higher allowances². 
• Discounts on contact lenses: Some vision plans partner with optical retailers and eye care affiliates to offer discounts or special promotions on contact lenses. Certain providers may even offer extra benefits when you purchase contact lenses, either in combination with or as an alternative to eyeglasses.³

Review your plan details or contact your insurance provider to determine how allowances and discounts are handled with your policy. Generally, allowances and discounts apply to the purchase of contacts, but you may also receive coverage for contact lens exams and fittings.

Does insurance cover contact lens exams?

A contact lens exam is the first thing you’ll need to do to get a prescription from your eye doctor. Keep in mind that a contact lens exam is different from a routine eye exam, but they may be done at the same time. During a contact lens exam, an eye care professional will check to see if contacts will work for your eyes, as well as measure your eyes to find the right contact lens for you.⁴

Some vision insurance plans will cover the price of a contact lens exam each year, or they’ll require a small copay. Ultimately, the extent of coverage will depend on the specific terms and conditions of your policy.

Does insurance cover contact lens fittings?

After the initial lens exam, your doctor will provide trial lenses for you to try on. Thelens fitting helps assess what size lenses you need, as well as their comfort and fit.⁴ While the fitting is usually performed during your eye exam, it’s typically charged separately as an additional service.³

Your vision plan may cover lens fitting fees, or you’ll pay a small copay. Review your policy to learn how contact fittings are covered.

How much are contacts without insurance?

The cost of contact lenses will depend on several factors, such as the brand of contact lenses, packaging, and the type of contacts you have.³ Here’s a breakdown of the average costs for contacts³:

Source: VisionCenter.org

In addition to the contact lens cost itself, there are fees for the contact exam and fitting. These fees can vary, but the average price for a contact lens exam is $40 to $240, and $25 to $250 for a fitting.³

How often can you get new contacts with insurance?

How often you can get a new prescription for contacts is determined by the terms and restrictions of your specific plan. But usually, you can get new contacts once a year or once every two years.⁵ Consult with your plan provider to understand the specified time frames available to you.

Does insurance cover contacts and glasses?

Most vision insurance plans offer coverage for both contact lenses and eyeglasses. However, individuals will typically need to choose between using their benefits on eyeglasses or contact lenses.² If your plan gives you an annual allowance, it’s up to you to decide how to use it.

Save on contacts with insurance

Utilizing the benefits of your vision insurance is a proactive way to maintain your vision and save on the costs of contact lenses and eyeglasses. If your employer offers vision insurance as an employee benefit, speak with your human resources (HR) department about how to enroll during open enrollment.