Many patients have both vision plans 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 PLANS cover routine vision wellness exams, along with determining a prescription for glasses and contacts. Vision plans DO NOT cover the diagnosis, management or treatment of eye problems related to medical diagnoses or symptoms, eye injuries, or eye conditions.
- MEDICAL INSURANCES are to be used for medical eye care for problems such as infections, dry eyes, allergies, or cataracts and annual examinations when you have a medical issue (such as high blood pressure or diabetes) that would affect your eye health and/or vision. Most medical plans do not cover routine services in the absence of a medical diagnosis or examinations for glasses, or routine vision problems such as nearsightedness, farsightedness, and astigmatism. We can attempt to coordinate benefits between your plans, to minimize your out-of-pocket expenses and you can use any glasses or contacts materials benefits with your vision plan.
MEDICARE DOES NOT COVER THE REFRACTION PART OF THE EXAM AND THERE IS A 20% CO-INSURANCE THAT IS DUE ON THE DATE OF THE VISIT. SOME MEDICARE SUPPLEMENTAL PLANS WILL PAY FOR THE 20% CO-INSURANCE AND RARELY PART OF THE REFRACTION.