Medical vs Vision Insurance

Medical vs Vision Insurance

Medical vs Vision Insurance

Medical vs Vision Insurance

Understanding your insurance prior to any service can help you avoid confusion and frustration. We would like to AVOID ANY MISCONCEPTIONS, and we hope that the following will help you better understand how your insurance coverage works.

Medical insurance DOES NOT cover vision-related issues such as routine exams, glasses, and contact lenses. Many people with medical insurance have a separate rider policy to cover routine eye exams. Typically, medical insurance policies usually cover only the comprehensive examination, but not the refraction (glasses prescription check). You are responsible for the cost of the refraction if your insurance is medical only.

VISION insurance covers comprehensive eye exams and refractions ONLY for purchasing glasses or fitting and purchasing contact lenses. Most vision plans do not cover ANY medical testing, diagnosis, consultation or treatment. If you have any medical concern that needs further follow-up, we would bill your subsequent appointments to your medical insurance.

MEDICAL concerns (Glaucoma, Dry Eyes, Diabetes, Macular Degeneration, Red Eyes, Floaters, Allergies, Styes, etc.) usually take priority over visual concerns because they can sometimes affect your glasses prescription. If your eye doctor has a suspicion for a disease that requires additional testing, information on your condition and necessary testing will be given to you.

Do I have to pay for my visit?
Regardless of whichever insurance plan you have, most plans do not cover 100% of expenses. Thus, you should expect some out-of-pocket costs for co-pays, deductibles, or co-insurances as required by your insurance policy. All co-pays are due at the time services are rendered. If your deductible has not yet been met, you will have to pay for the service until your deductible is met.

The cost of services rendered cannot be accurately determined until your insurance company has been billed. We will do our best to provide you with an estimate of the cost of the services before or during your appointment. The cost for these services must be paid before materials (glasses or contacts lens) can be ordered.

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