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If you are an advisor, chances are that most of your clients have a vision care benefit. You know that vision care is known as a dollars in/dollars out benefit, meaning that those who wear glasses typically claim the maximum plan benefit every 24 months. For some, purchasing new glasses is driven by prescription changes, but for others it can be more about upgrading frames. Vision care benefits are in higher demand than ever, in part because of an aging employee population.
As we age, our risk of chronic disease increases, including chronic vision and vision-related disease, but current vision care plans were not designed to meet those needs. A 2019 study conducted on behalf of the Canadian Association of Optometrists (CAO) examined whether private plans meet the needs of Canadian plan members, particularly with respect to disease prevention, early diagnosis, management, and treatment. Most do not, and the results were not surprising.
Like many other areas of health care, vision care technology has developed substantially in recent years to include tests that optometrists can use for early detection, diagnosis and monitoring of several chronic conditions that can result in vision loss. Only a minority of plan members will require more frequent exams and more advanced care, but access to these services can prevent serious complications and vision loss from conditions that include age related macular degeneration (AMD) (=/+ age 55), Dry Eye (> age 50), Glaucoma (> age 40) and Diabetes (ages 40-59).
What does this mean for your clients and their vision care plans? The CAO has developed a guidebook to vision care that includes recommendations for new vision care plan standards and they have taken the time to work with an actuarial firm to ensure their recommendations have minimal impact on overall health plan costs.