Let me start with some good news: A significant number of Americans have vision insurance. In fact, according to a recent study by the National Association of Vision Care Plans, about 85 million Americans have such insurance.

Now the bad news. Vision-related problems, such as diabetic retinopathy, cataracts, macular degeneration, and gradual vision decline, have been on the rise for the last ten years.

Once again, some good news. Now it is quite easy to insure yourself against such diseases or deficiencies. But you have to be smart about it and be prepared to shop around, as every insurance company has their hot spots regarding what condition is “high risk.”

Here are some tips for buying insurance.

1. Insurance company. It’s important to be with an insurance company that is a leader in the vision insurance market. So who are the top vision insurance companies in the US?

The top five insurance companies offering vision insurance in the US are EyeMed, VSP, Davis, Optum and CIGNA. Of these, the top three have around 250 million policyholders. While big isn’t necessarily good or positive, it does represent a couple of positive attributes: Being specialists, these insurance companies can be trusted to be generally consistent, have a good reputation when it comes to claims and paperwork handling, and probably are more attuned to new treatments for vision-related problems.

2. What are you trying to cover?

As with any other part of your body or medical care, there are three levels you may want to cover with vision insurance.

= general and preventive maintenance. These cover vision tests, tests for age-related problems such as glaucoma, and macular problems.

= special viewing conditions

= diabetes-related diseases such as retinopathy

=improved lens coverage

Different plans have a different approach when it comes to vision-related coverage, so be careful to read the coverage section of the policy before you sign up.

3. Refund Policy

Does the insurance company make you pay first and get reimbursed yourself, or will they bill the insurance directly later? You are not in a position to understand what is covered and what is not. It should be the doctor’s office. Many optical doctors take the easy way out and let you fight the insurance company. Go with the insurance company that has doctors that accept insurance and bill the insurance directly. That way, you’re only responsible for the copay and deductible, not the entire bill.

4. Access to doctors.

Many treatments require you to take special medications and not drive. Choose a company that has extensive medical coverage so you and your spouse don’t have to drive far.

In short, vision may not be as critical as your health policy, but nonetheless, your eyes are probably the most important organ in your body, so when it comes to covering them, be very smart and careful.

Good luck.