If you wear both glasses and contacts, you have probably run into the same rule on most vision plans: in each benefit period, you can use your eyewear benefit for glasses or contacts, but usually not both. Understanding how the allowances work helps you get the most value.
How a glasses benefit usually works
- Frame allowance: a set dollar amount toward frames; you pay anything above it.
- Lenses: standard single-vision, bifocal, or trifocal lenses covered after a copay.
- Add-ons: coatings, progressives, or high-index lenses may carry extra copays.
- Frequency: typically every 12 or 24 months.
How a contacts benefit usually works
- Contact lens allowance: a set dollar amount toward lenses, used instead of the glasses benefit.
- Fitting exam: a contact lens fitting is separate from the routine eye exam and may have its own copay.
- Medically necessary contacts for certain conditions may be covered in full.
Which should you choose?
| If you mostly wear… | Consider |
|---|---|
| Glasses daily, contacts rarely | Use the benefit on glasses |
| Contacts daily | Use the benefit on a year of contacts |
| Both equally | Alternate by year if your plan allows, or buy the second item at a discount |
Get more from your allowance
- Use in-network providers, where allowances go furthest.
- Ask for the plan's member discount on a second pair or extra contacts.
- Pay for what the allowance does not cover with HSA or FSA dollars — see using HSA and FSA money.
- Track your benefit period so you do not leave an allowance unused.
Families
Each covered family member has their own allowance. Children's glasses are often covered through ACA health plans — see kids' vision coverage.
Not sure coverage pays off? Read is vision insurance worth it?
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