Here's something most optometrists don't realize until it's too late: your practice faces more insurance-worthy risks in a single day than most businesses do in a month. Between handling expensive diagnostic equipment, storing protected health information for hundreds of patients, and making clinical decisions that affect people's vision, you're juggling multiple liability exposures simultaneously. That's why having the right insurance isn't just smart—in many states, it's legally required.
This checklist breaks down exactly what coverage your optometry practice needs, what's optional but worth considering, and when to add new policies as your practice grows. Whether you're just opening your doors or you've been in practice for years, this guide will help you identify gaps in your coverage before they become expensive problems.
Essential Coverage: What You Must Have
Let's start with the non-negotiables. These are the insurance policies that either state law requires or that you absolutely need to operate safely.
Professional liability insurance (malpractice insurance) tops the list. This protects you when a patient claims you made an error in diagnosis, prescribed the wrong lens correction, or missed detecting an eye disease during an exam. Many states legally require this coverage. For example, Texas mandates minimum coverage of $200,000 per claim with a $600,000 aggregate limit for all claims in a year. Most optometrists opt for higher limits though—typically $1 million per occurrence and $3 million aggregate, or even $2 million per occurrence and $4 million aggregate. The average cost runs about $42 per month, which is remarkably affordable given what's at stake.
General liability insurance covers third-party bodily injury and property damage claims. Think: a patient trips over your reception area rug and breaks their wrist, or your employee accidentally damages a landlord's property. Most commercial leases require proof of general liability before you can even sign. This coverage also runs around $42 per month on average, making it one of the most cost-effective protections you can buy.
Workers' compensation insurance is mandatory in most states the moment you hire your first employee. It covers medical expenses, disability benefits, and lost wages if an employee gets injured on the job. Even if your optometric assistant just tweaks their back moving equipment or develops carpal tunnel from computer work, workers' comp handles it. Skip this coverage and you're personally liable for those costs—plus potential fines from your state.
Commercial property insurance protects your physical assets: your office space, furniture, frame inventory, and most importantly, your specialized equipment. A single OCT machine can cost $40,000, and your phoropters, slit lamps, and autorefractors add up fast. Fire, theft, vandalism, or storm damage could wipe out hundreds of thousands of dollars in equipment. Standard property coverage handles this, though you'll want to verify that your policy limits actually reflect the replacement cost of your specialized optometry equipment.
Critical Optional Coverage You Shouldn't Skip
These policies aren't legally required, but skipping them leaves you dangerously exposed. Consider them essential unless you have very specific reasons they don't apply to your practice.
Cyber liability insurance has become absolutely critical for healthcare practices. Small businesses account for 43% of cyberattacks, and healthcare experiences over 28% of all data breaches. If hackers access your patient records, you're looking at an average cost of $240 per record for recovery, notification, credit monitoring, and legal fees. A practice with 1,000 patient records could face a $240,000 bill from a single breach. A good coverage rule is two times your monthly revenue—so if you bring in $200,000 monthly, carry at least $400,000 in cyber liability coverage.
Business interruption insurance keeps your practice financially afloat when you can't operate. If a fire, flood, or other covered disaster forces you to close temporarily, this coverage pays your ongoing expenses: rent, payroll, loan payments, and utilities. Without it, you're draining personal savings or taking loans to keep your business alive while generating zero revenue. This coverage often comes bundled with property insurance or as part of a Business Owner's Policy.
Business Owner's Policy (BOP) bundles general liability, property, and business interruption coverage into one package at a discounted rate. Optometry practices pay an average of $97 per month ($1,159 annually) for a BOP—significantly less than buying these policies separately. If you need both property and liability coverage, a BOP is almost always your most cost-effective option.
Commercial auto insurance is required by most states if your practice owns vehicles or if you use your personal vehicle for business purposes regularly (like picking up frame inventory or making bank deposits). Personal auto policies typically exclude coverage for business use, leaving you personally liable if you're in an accident while running practice errands.
When to Add or Update Coverage
Your insurance needs change as your practice evolves. Here are the trigger points when you should add coverage or increase your limits:
Hiring your first employee means you need workers' comp immediately—before they start their first shift, not after. You'll also want to review your general liability limits since more people in your practice means more potential for accidents. When you hire staff who handle billing or patient data, that's the perfect time to add employment practices liability insurance (EPLI), which protects you from wrongful termination, discrimination, and harassment claims.
Adding new equipment or technology requires updating your property insurance. When you buy that new $50,000 fundus camera or upgrade your entire practice management system, call your insurer to schedule additional coverage. Don't assume your existing property limits automatically cover new purchases—many policies have sublimits for specialized equipment.
Expanding your services—like adding contact lens fitting, low vision therapy, or medical optometry services—means reassessing your professional liability coverage. Your policy should explicitly cover all procedures you perform. Some insurers automatically update coverage as state laws change to permit new services, but verify this with your provider.
Opening additional locations multiplies your insurance needs. Each location needs property coverage, and your liability limits should increase to reflect your expanded exposure. You'll also need additional workers' comp coverage if you hire staff for the new location.
Annual Review Checklist
Set a recurring calendar reminder to review your insurance annually, ideally 60 days before your policies renew. Here's what to check:
Do your property insurance limits reflect current replacement costs for all equipment? Calculate the total value of all your diagnostic equipment, computers, furniture, and frame inventory. Inflation and equipment upgrades mean this number increases every year.
Are your liability limits still adequate given your practice revenue and patient volume? As your practice grows, your exposure grows too. If you've doubled your patient base, you might need to increase your professional liability limits.
Does your cyber liability coverage match the two-times-monthly-revenue rule? If your revenue has grown, your cyber coverage should grow with it.
Have you added or changed any services that require updated professional liability coverage? Review your policy to confirm all your current procedures are explicitly covered.
Are you paying for coverage you no longer need? If you sold a business vehicle or closed a satellite office, you might be able to reduce premiums by adjusting your coverage.
Getting Started with the Right Coverage
The smartest move is working with an insurance broker who specializes in optometry or healthcare practices. They understand the unique risks you face and can often bundle policies for better rates. Come prepared with information about your practice: square footage, number of employees, annual revenue, equipment inventory value, and services you provide.
Don't just buy the minimum required coverage and hope for the best. A comprehensive insurance portfolio costs less than you'd think—many optometry practices pay under $200 per month for a BOP, professional liability, and cyber coverage combined. That's a fraction of what you'd lose from a single uncovered lawsuit or equipment theft. Your insurance isn't just a legal requirement or a line item expense—it's what keeps your practice standing when everything else goes wrong.
