What is Vision insurance, and how is it different from Medical insurance?
A Vision insurance policy is different from your health insurance policy. Regular medical health insurance protects you from unexpected costs for eye injury or disease. In contrast, vision insurance provides an added wellness benefit for healthy eye exams, which includes routine eye care, prescription eyewear and contact lenses, and other vision services at a reduced cost. Some examples of vision insurance include Davis Vision, Spectera, Eyemed, and VSP.
What does vision insurance cover?
Most vision insurance plans include the following benefits:
- Annual Vision exams
- Eyeglass frames
- Eyeglass lenses
- Contact lenses
Check with your plan to see if your benefits cover you once every year or once every two years. Eyeglass frames and lenses and contact lenses can usually be purchased at a discount, but not every plan has this benefit.
What does my vision insurance NOT cover?
Vision plans do not cover any part of an eye exam considered “medical”. For example, vision insurance will not cover vision loss, floaters, dry eyes, allergies, infections, eye disease, or eye exams for complication from diabetes. If you need medication the doctor will not be able to give you a prescription if you are using a vision insurance.
Additionally, some vision insurance plans do not cover contact lens fittings (for first-time wearers or established wearers that need to switch to a new brand) or yearly contact lens evaluations.
Can I use my vision insurance and my medical insurance for a joint exam on the same day?
No. By law, we cannot bill two different types of insurance on one day. There are two Alternatives.
First, we can always schedule your medical and vision visits on separate days, allowing us to bill your insurances on different days. You may have to go through some repetitive parts of the exam on those days because by law there are certain things the eye doctor must document at every visit.
If you need to schedule your medical and refraction exam on the same day, another option is billing your medical insurance for the medical exam (don’t forget, this may include a copayment at the time of your visit) and paying the additional flat rate for a refraction ($50.00).
Why is insurance so complicated?
Good question! We don’t make the rules, we just follow them. You can call the phone number on the back of our insurance card or look up your insurance policy details online. Ultimately it is your responsibility to understand the policies of your insurance companies, both medical and vision. Please call us if you have any remaining questions.