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Does the Affordable Care Act Lose Sight of Vision Benefits?

ObamaCareThe Affordable Care Act - also known as the Patient Protection and Affordable Care Act as well as ObamaCare – was first signed into law in 2010 by President Barack Obama. It has represented the single largest overhaul of the healthcare system in the United States since Medicare and Medicaid passed in 1965. As a result, the ACA has been a very controversial proposition on both sides of the aisle. With experts and amateurs alike discussing whether or not the Affordable Care Act is constitutional, one area that people haven’t really spent much time talking about are the inherent vision benefits (or lack thereof, depending on who you ask).

To put it simply, vision benefits and vision insurance definitely have a place within the Affordable Care Act. Some people, however, might not like how narrow that place actually is. The Act itself actually has a number of different sections that directly affect the vision benefits that individuals are able to obtain.

Public Exchange vs. Private Insurance

According to the Ameritas Group, the Affordable Care Act stipulates that an adult vision plan that is offered in the public exchange can in no way be less expensive than those offered by stand-alone companies that offer vision insurance. Additionally, there are certain prerequisites for vision insurance that is to be combined with medical insurance that individuals will have to meet before such a plan can be obtained.

You might have to meet the deductible specified by a plan before any vision expenses will be paid, for example. This type of stipulation is definitely a potential issue for people with combined medical plans. If your plan offers combined dental and vision benefits, it may have a large combined deductible. As a result, you would have to spend a great deal of money out-of-pocket before any covered vision procedures would be paid in full through a medical plan obtained on the exchange marketplace.

These stipulations may not actually matter for our individual coverage, however, as much as many people seem to think. According to Benefits Pro, vision benefits (along with dental benefits) that are designed to be sold as stand-alone policies are themselves not actually subject to most of the provisions in the Affordable Care Act. The only types of policies that are a part of what are being referred to as “Essential Health Benefit Packages” are those which are required to be offered to both individuals and small employers.

Additionally, if you’re worried about losing your existing vision benefits that you have through your employer, you can relax. Employers will be in no way required to purchase health insurance for their employees through health insurance exchanges under the Affordable Care Act. Employers can keep their current insurance carriers and all of the vision benefits that come with them should they so choose. If you have excellent vision benefits through your existing policy, you aren’t going to be forced to change to something that won’t work as well for your own specific situation.

Adults and Minors to Have Different Vision Plans

One potential downside to the stipulations in the Affordable Care Act comes from the fact that parents will likely have different vision plans than those of their children. As a result, it may be difficult to keep track of separate plans and separate appointments or procedures, which can make it unnecessarily difficult to monitor and control how much money you’re actually spending.

Vision Benefits Will Still be in Sight

The Affordable Care Act definitely doesn’t lose sight of vision benefits in the way that many people think it does. Vision benefits are definitely included in a variety of ways. Where the ACA comes up short, however, is just how those vision benefits are regulated. As a result, individuals in certain situations may find it more difficult-and more expensive-to get the healthcare they need under the revised plan.

Do you have any questions? Please ask.