3 Things to Know About No-Gap Eyewear Coverage

If your health insurance coverage includes ancillary coverage, then you might get some help with the costs of prescription glasses and contact lenses. For example, your policy might give you a no-gap payment option.

If you don't have no-gap coverage, then you have to fund the difference between the actual cost of your glasses or lenses and the amount your insurer pays towards them. If you have no-gap coverage, then your insurance company pays the full cost based on your policy's terms and conditions.

While a no-gap option is useful, you don't necessarily get standardised benefits here. So, if you're comparing health funds and want eyewear benefits, then you choose your policy carefully. What do you need to know?

1. You Might Have to Use Preferred Opticians

If your insurance company offers no-gap eyewear benefits, then you might have some limits on where you can buy your glasses or contact lenses. Typically, insurance companies do deals with various providers; you can't necessarily use any optician you choose.

Here, insurers work with certain companies to provide a no-gap range. If you buy glasses or contact lenses from a preferred supplier's range, then your insurer covers your costs. If you use a different optician or store or buy out of range, then your insurance won't be valid for this purchase.

Before you choose a policy, check out where you can buy your glasses or contact lenses. Different insurance companies use different providers, so try to find one that includes opticians you're happy to use with a wide range of product options.

2. No-Gap Benefits Vary

No-gap benefits vary according to the insurer you use and their policy plans. For example, some insurance companies give you higher claim amounts than others. Some offer a range of plans with different limits and benefit amounts.

This isn't so much of an issue if you have a regular single-vision prescription. No-gap benefits work well for these prescriptions.

However, if you have a more complex prescription, say if you need special lenses such as bifocals, then you might not qualify for no-gap coverage on a standard policy. You might need to pay extra to get extra coverage or you might need to find a company that does include different types of prescriptions.

3. You Have Annual No-Gap Limits

Insurers usually have an annual no-gap eyewear limit. So, for example, you might be given an allowance of $200. This is the maximum amount you can claim back on glasses or contact lenses in your set yearly limit. If you spend more in any given year, you'll have to cover your costs.

To find out more, check out the benefits of the no-gap spectacle in your shortlisted health insurance policies.

For more info, contact a local company like Darling Downs Optometrist.