Thursday, February 28, 2013

Vision Insurance Should be Part of Regular Health Insurance

Vision loss affects millions of Americans, sometimes due to significant eyes disease. The main eye disease causing vision loss includes glaucoma, age-related macular degeneration (ARMD), and cataracts. Glaucoma is a condition in which increased pressure in the eye can lead to gradual loss of vision.

ARMD is a loss of vision in the center of the visual field (the macula) because of damage to the retina. The retina is an area at the back of the eye that is sensitive to light. Cataracts is a darkening of the lens in the eye. The lens is an organ located between the colored part of the eye, that bends light as it enters the eye.

The best way to prevent permanent vision loss from these and other conditions is early detection and treatment, which can be accomplished by periodic eye checkups. People may avoid early screenings if they do not have symptoms, which can happen when a good eye compensates for a bad eye. It is also likely that people will be less likely to go for preventive vision screenings if they do not have vision insurance. Many people have regular health insurance but do not have vision insurance because it is a separate insurance benefit. In efforts to lower healthcare costs, which is increasingly happening due to healthcare reform, vision coverage is often dropped.

In an upcoming issue of JAMA Ophthalmology, researchers reported on the results of a large study with 27,152 adults (ages 40 to 65 years) examining the likelihood of an eye care visit within the past year and of self-reported visual impairment in those with vision insurance versus those who did not have vision insurance. Of the adults studied, 3158 (11.6%) had glaucoma, cataracts, and/or ARMD.

About 40% of the overall sample and those with eye diseases did not have vision insurance. The researchers found that people with vision insurance were more likely than those without vision insurance to have eye care visits, to report no difficulty recognizing friends across the street, and to report no difficulty reading printed material. Those who had an eye care visit from the total sample and eye disease sample reported being better able to recognize friends from across the street and had no difficulty reading printed material.

The researchers concluded that lack of vision insurance interferes with eye care services, which may lead to permanent vision damage. The researchers argued that preventive eye car should stop being a separate insurance benefit and should be a mandatory part of all health plans. I agree with them and would also say the same thing for dental insurance…put them all under one comprehensive plan.

Suggested reading: Reader's Digest Guide to Eye Care: Common Vision Problems, from Dry Eye to Macular Degeneration
Reference: Li YJ, Xirasagar S, Pumkam C, Krishnaswamy M, Bennett CL. (2013, in press). Vision Insurance, Eye Care Visits, and Vision Impairment Among Working-Age Adults in the United States. JAMA Ophthalmology.

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