Many people need vision correction as a necessity for daily living.
Eyeglasses come at a high cost which can be surprising when you go to pick them up after ordering your new pair.
Eyeglasses are so expensive due to insurance coverage logistics, outsourcing costs for manufacturing, patient customization, market control, and business operating costs. Consumers are left with expensive options for eyeglasses when there are lots of “middlemen” involved in the process.
1. Insurance Coverage Logistics
Similar to dental insurance, eye insurance is a supplemental policy or add-on to health insurance.
Figuring out if insurance covers your eye exam and glasses can be tricky. It all depends on your policy.
Some policies have no vision coverage, others cover routine exams, and others only cover medical eye issues.
Services may be fully or partially covered, require a copay or deductible, limit the number of visits per year, cover lenses but not frames, and other variations.
Some insurances limit what brands or styles of glasses will be covered as well.
It is best to know the fine details of your insurance policy or call the doctor’s office ahead of time to have them help you navigate coverage.
Routine eye exams tend to result in a diagnosis of a common issue, such as near- or farsightedness, or astigmatism.
If a medical issue is found during a routine exam, then the eye specialist will bill that appointment as a medical one.
Or, if a patient comes into the office with an issue that requires immediate attention, this is also considered a medical appointment.
Medical conditions could include macular degeneration, cataracts, detached retina, glaucoma, and more.
These are more serious conditions that could require surgery and additional appointments.
Your medical health insurance may cover these even if you do not have vision insurance.
After an exam, you will then purchase eyeglasses or receive treatment. The cost of this visit adds to the total amount of money spent when getting eyeglasses.
The Vision Council estimates that approximately three-quarters of U.S. adults need vision correction. If you factor in children wearing glasses, the number is going to be even higher.
Millions of people need glasses, and when demand is high, so is the cost.
Additionally, vision needs can change over time. Children that wear glasses get bigger and need larger eyeglasses in subsequent years.
Vision prescriptions can change over time as well, and routine exams will fine-tune your vision needs. This increases the demand for updated eyeglasses in a patient’s lifetime.
3. Eye Specialist
Routine and medical exams are done by either an optometrist or an ophthalmologist.
Optometrists are not medical doctors but can perform standard eye exams and prescribe eye correction.
If they notice eye abnormalities, they will refer you to an ophthalmologist for diagnosis. They will attend higher education for 8 or 9 years.
Ophthalmologists are medical doctors that perform the standard eye exam and check for eye diseases. They can also perform surgery and prescribe medicine. They attend higher education for at least 12 years.
Highly trained eye professionals are going to cost more since they have received many years of specialized education that only they can offer for your eye health.
4. Eyeglass Lenses: Customized
Whether you buy them from the doctor’s office or a retailer, lenses can only be made with a prescription for them in hand.
Many lenses today are made from plastic and are crafted specifically for your eyes’ needs.
If you have eye issues beyond the scope of near- or farsightedness, your lenses may cost even more. These include the need for bi- or trifocals, thicker lenses to treat amblyopia (“lazy eye”), and so on.
Additionally, lenses are crafted to be scratch-resistant and anti-reflective to give the wearer a better product. Lenses will vary in diameter depending on the frames you choose, so the bigger the lens, the more it will cost.
Patients may choose to have their lenses offer protection from blue light or automatically darken in sunlight (photochromic). Generally, these add-ons are not typically covered by insurance and add to the overall cost.
The manufacturing processes and equipment to create customized lenses for an individual costs money.
5. Eyeglass Frames: Fit, Branding, Materials
Frames can vary drastically in how much they cost, from less than $10 to over $1,000. This is largely in part due to fit, branding, and material composition.
When choosing frames, the eye specialist will measure the distance from the center of your face to each eye. This is to ensure that the lenses sit correctly in them for your vision correction.
You should try on frames to make sure that they are wide enough for your face shape and sit comfortably on your ears. This could potentially limit your options when trying to find frames that you like that also work with your face shape.
This could result in limited options with higher pricing.
Frames with a popular brand name on them tend to cost significantly more than generic ones.
Brand names offer status and luxury, and the sale prices for them can be marked up by over 1000%, with company price gouging and control over the industry.
EssilorLuxottica owns many luxury branding licenses and retailers. They also own a vision insurance company called EyeMed. This gives them a lot of control over the market by reducing competition and therefore can control pricing.
Materials And Design
Frames are made from acetate or plastic formulations with varying compositions, or they are made of metal such as stainless steel or titanium.
In addition to that eyeglasses may have a nose piece to help them sit securely on the bridge of the nose.
Frames are offered in different colors, made with hypoallergenic materials, and accented with jewels or other unique designs.
As a result, prices will vary depending on what they are made out of and how they are designed.
6. Manufacturing Process
Eyeglasses are manufactured in many steps by 3rd parties and are not made at the doctor’s office.
Generally, eyeglasses are made for the consumer following this process:
- Frames are designed and produced. Costs include manufacturing machines and labor, profit margins, and licensing fees for branding.
- The manufacturer sells the frames to wholesale distributors or retailers. Costs include money used for warehousing, distribution and shipping, and profit margins.
- Frames are sent to a different 3rd party lens manufacturer to assemble the eyeglasses. They are then sent back to the retailer. Costs include lens manufacturing, labor, profit margins, and shipping.
- The eyeglasses are then ready for the patient. The doctor’s office will make sure that they fit properly on the patient’s face and that they work as intended.
Some people opt for purchasing eyeglasses online (with a prescription) where both lenses and frames are made by one company and then shipped to their home. It is then up to the patient to make sure they fit correctly on the face.
By taking out some of the “middlemen”, the overall cost can be lower.
7. Practice Operating Costs
Eye specialists will either work for a company or group or have their private practice. They are required to follow rules and regulations.
Eye specialists will either absorb the cost of working for a group or pay for it themselves.
These costs include:
- Building rent or mortgage
- Local taxes and codes
- Insurances (malpractice, employee benefits)
- Maintenance of technology and machines
- Regulations/Fees (drug administration, accommodations for those with disabilities, etc.)
8. Equipment, Supplies, Sterilization
Eye doctors use specialized equipment and technology to care for their patients. These are expensive and must be kept in working order. Other supplies may include eye drops and disposable items for individual use.
Sterilization practices must take place in between patients and this will add to the overall costs as well.
9. Practice Location
Costs may vary depending on where the practice is located. Practices could be located in a mall, storefront, or as a private practice.
Each of these brick-and-mortar places will have different rents or codes that affect the business taxes as well.
Additionally, practices may cost more in the city than in rural areas and can vary from state to state.
Costs associated with the market, manufacturing, and customization of eyeglasses exorbitantly raise the final out-of-pocket costs for patients who need eyewear.
In addition to that, many insurances do not cover or only partially cover some vision services.
Eye correction is essential to daily living, so consumers are left with the challenging task of trying to find affordable eyewear.