A lot of people confuse Vision Insurance and Medical Insurance up. To help our patients understand the difference between the two please review the section below.
Vision Insurance
Vision insurance is an annual benefit that is designed to be used during a routine comprehensive eye exam. Insurance companies define a “routine” eye exam as one where an eye doctor would perform refraction, pressure tests and dilation of your eyes to check your vision and generate a prescription for glasses and/or contact lenses, in order to help you see better. The conditions diagnosed within this exam are the following:
- Myopia (Near Sightedness)
- Hyperopia (Far Sightedness)
- Presbyopia
- Astigmatism
It is important to know, a large chunk of insurances to do not fully contribute towards Contact Lens exams, but do pay for a huge portion towards your Glasses or Contact Lens purchases.
This is why we recommend all our patients contact their insurance companies to understand their Vision Insurance coverages and choose Vision Insurance plans with a good Contact Lens coverage. This will minimize their out of pocket expense.
Advanced Eye Clinic takes the following Vision Insurances below:
- Davis Vision
- VSP
- FEP Blue Vision
- United Health Care/Spectera
- Cigna Vision
- Aetna Vision
- EyeMed Vision
- Superior Vision
- Always Vision
- Avesis
- Humana Vision
And many more.
Medical Insurance
On the other hand, a Medical Insurance is used simply when there is a medical reason to look at your eyes. An emergency visit, or one focused on a specific eye problem, would be submitted to medical insurance. Some examples of a medical visit are: eye infection, floaters, eyelids styes, dry eyes, glaucoma treatment, loss of vision, foreign object removal etc.
Medical Insurances are also used to pay towards a comprehensive eye exam when there an existing medical condition that affect the eyes example diabetes, cataracts, or any of the previously listed reasons. During each of these above listed cases, insurances require us to submit claims to a patient’s medical insurance, not vision insurance.
To help illustrate the difference better, if a patient came to our office for a routine eye exam but during the exam we discover an underlying medical condition, that visit should be billed under a Medical Exam. The refraction portion of the exam goes to the Vision Insurance.
We understand these insurance differences can be confusing, but fortunately for our patients we are experts at this!
If you have both medical and vision insurance plans, please call us today! As per insurance guidelines, our office can help understand your benefits to minimize your out-of-pocket costs.
Advanced Eye Clinic takes the following Medical Insurances below:
· Medicare
· Cigna
· Tricare
· Medicaid
