Vision vs. Medical Insurance

Many people have both vision and medical insurance. They are very different in terms of the services they cover and it’s important for our patients to understand these differences.

Vision coverage (EyeMed, NVA, VSP, etc.) is mainly designed to determine a prescription for glasses or contacts and is not equipped to deal with complex medical conditions and/or diagnoses. It does allow for screenings of conditions, but once they are determined, we are then required to file the medical insurance for those services.

When a medical condition is present  (such as diabetes, cataracts, dry eye, floaters, etc.) it is necessary to file the visit with your major medical carrier (United Healthcare, Medicare, Humana, etc.) and the co-pays set by your insurer will apply as well as any non-covered services. Insurance carriers set these rules and our office is legally obligated to be compliant. In most cases, there is no way to guarantee which plan we will be required to file prior to the examination.

We make every effort to be on every major carrier for your convenience, and we will file those claims for you. In the event that we do not accept your insurance , we will provide you with an itemized receipt so that you may file with your carrier for reimbursement. If you have any questions, please let us know.