Association of Gaps in Medical Insurance Coverage with Vision Care Benefits Among US Adults.

Background: In the US, routine vision care and medical services are often covered by separate insurance plans. Unmet needs for vision care are more common among adults with gaps in medical coverage, but it is unclear how gaps in medical coverage correlate with lack of vision benefits among currently insured adults. We hypothesized that gaps in medical coverage in the past 12 months would be associated with lack of coverage for vision care among US adults currently covered by commercial medical insurance.

Methods: We included adults age 18-65 with private insurance who participated in the 2019-2022 National Health Interview Survey. The primary outcome was any coverage for vision care services, and the secondary outcome was a source of vision coverage (primary health insurance policy as compared to single-service plans only).

Results: Based on a sample of 50,000 participants, we estimated 4% of commercially insured adults recently experienced coverage gaps, and 75% had coverage for vision care services. On multivariable analysis, commercially insured adults with recent gaps in medical coverage were more likely to lack coverage for vision care at the time of the survey, compared to adults with continuous medical coverage (odds ratio [OR], 0.77; 95% CI: 0.68, 0.86). However, medical coverage gaps were not associated with source of vision care coverage.

Conclusions: Gaps in medical insurance coverage were associated with lower likelihood of vision care coverage compared to continuous medical coverage. Protecting continuity of health insurance may support access to vision benefits and reduce gaps in routine vision care.