What to Know About Vision Insurance Copays
Participation is not a guarantee of insurance coverage. If patient qualifies, the Repatha ® Copay Card may cover out-of-pocket costs for Repatha ® up to an annual maximum dollar limit. Military and veterans TRICARE for Life provides health insurance for qualified service members, National Guard and Reserve members. To find out more, go to www.tricare.mil or call 1-888-874-9378. Veterans Affairs (VA) benefits may be available to veterans who qualify for care.
You’ve likely encountered copays when using health insurance to visit a family physician or urgent care facility. Likewise, you’ll have copays when you see an eye doctor and use your vision insurance. Although copays are not new, there are a few common questions people typically ask about their vision plan copays. Here are the things you should know:
Insurance Copay Calculator
What is a copay?
When you visit an eye doctor, your vision copay is a fixed amount you pay for services.So when you get an eye exam, you pay a copay and your plan covers the rest. Your vision plan identifies what your copay is for vision services.
Why is a copay necessary?
Co Pays For Health Insurance
Copays help you manage your budget by knowing ahead of time what you’ll have to pay during your visit.
Are copays the same for all vision insurance plans?
Copays can differ with each plan. You’ll typically find a copay for your exam, one for your glasses, and sometimes copays are associated with specific lens enhancements. That’s why it’s important to review your plan benefits.
What if I have other questions about copays or my plan?
Any time you have questions about your VSP® vision plan copays or your insurance plan in general, you can speak with our knowledgeable customer service team at 800.785.0699. Our service center is open Monday through Friday from 7a.m. to 7p.m. Central Time. We’re happy to do what we can to help you make the most of your VSP vision insurance!
Individual Vision Plan members not only love the benefits of low copays, they’re also happy about the frame coverage and provider network offered through their vision insurance plans. If you'd like to look at plans that are ideal for you and your family, visit our vision plan finder today.
Here’s what VSP Direct members have to say:
“I work on computers every day, so to be able to get a pair of computer glasses and only have to pay the copay is excellent.”
– D. Rimes
“My old insurance didn't cover enough for designer frames. But since I've had VSP, I can choose Gucci or Bebe and not go broke in the process.”
– D. Fletcher
“There was a great selection of providers in our area, including one close to my house.”
– M. Simmons
Browse: Home > Ambetter – Illinois Health Plans
Free Online Quote
2020 Ambetter Provider Finder
2020 Ambetter Hospital List
Coverage Area: Cook County, DuPage County
Our Rating:
Ambetter is one of 5 carriers in Illinois for 2020, and one of 3 who is covering Cook & DuPage counties. They are currently only offering Silver & Gold plans, which can only be enrolled on the exchange. They also offer plans bundled with optional vision & dental plans.
Ambetter is a good choice for anyone who qualifies for Cost Sharing reductions, as well as for people who are more concerned about their prescription drug coverage (more copays then similar Blue Cross plans) vs gaining access to a wide provider & hospital network.
Hospital List – Chicago Area
| Hospital | Address | Phone Number | |
|---|---|---|---|
| Kindred Chicago Lakeshore | 6130 North Sheridan Road | Chicago, IL 60677 | (773) 381-1222 |
| Mt Sinai Hospital | 2750 W 15th Place | Chicago, IL 60608 | (773) 542-2000 |
| Thorek Memorial Hospital | 850 West Irving Park | Chicago, IL 60613 | (773) 525-6780 |
| Louis A Weiss Memorial Hospital | 4646 North Marine Drive | Chicago, IL 60640 | (773) 878-8700 |
| Kindred Hospital Chicago North | 2544 W Montrose Avenue | Chicago, IL 60618 | (773) 267-2622 |
| Kindred Chicago Central Hospital | 4058 W Melrose Street | Chicago, IL 60677 | (773) 736-7000 |
| Saint Bernard Hospital | 326 W 64th Street | Chicago, IL 60621 | (773) 962-3900 |
| Swedish Covenant Hospital | 5145 North California Avenue | Chicago, IL 60625 | (773) 878-8200 |
| Holy Cross Hospital | 2701 W 68th Street | Chicago, IL 60629 | (773) 884-1602 |
2020 Plan Comparison
Note: Silver plans on the exchange may qualify for Cost Sharing Reduction, meaning you may see different deductibles and copayments based on if you qualify based on your income level.
Insurance Copay Meaning
| Plans | Ambetter Balanced Care 11 (2020) | Ambetter Balanced Care 2 (2020) | Ambetter Balanced Care 1 (2020) | Ambetter Balanced Care 12 Standardized (2020) | Ambetter Secure Care 1 (2020) with 3 Free PCP Visits |
|---|---|---|---|---|---|
| DEDUCTIBLE | $0 | $6,500 | $5,500 | $3,500 | $1,000 |
| MAX OUT OF POCKET | $2,700 | $6,500 | $6,500 | $7,350 | $6,350 |
| NETWORK | HMO | HMO | HMO | HMO | HMO |
| METAL LEVEL | Silver | Silver | Silver | Silver | Gold |
| COPAYS | |||||
| PRIMARY CARE | $8 | $30 | $30 | $30 | 20% Coinsurance after deductible |
| SPECIALIST | $15 | $60 | $60 | $65 | 20% Coinsurance after deductible |
| GENERIC DRUGS | $8 | $15 | $10 | $15 | $10 |
| BRAND DRUGS | $30 | $50 | $50 | $50 | $25 Copay after deductible |
| NON PREFERRED BRAND DRUGS | 50% | No Charge after Deductible | 20% Coinsurance after deductible | $100 | $75 Copay after deductible |
| SPECIALTY DRUGS | 50% | No Charge after Deductible | 20% Coinsurance after deductible | 40% Coinsurance after deductible | 30% Coinsurance after deductible |