Insurance for Eyecare
Medical and Vision Plans - What's the Difference?
Medical Insurance covers a patient’s eye care visit when the doctor determines a medical diagnosis as to the outcome of a patient’s reason for their visit. Examples can be: eye infections, foreign body removal, sudden onset of flashes and floaters, double vision, eye pain, dry eye problems, blurred vision, headache, allergy eye issues, and many other symptoms. Medical Insurance would also cover eye doctor visits to monitor progressive eye conditions such as cataracts, glaucoma, vitreous changes, corneal conditions, diabetic retinopathy, macular degeneration, and also when a patient’s general health issues and medications may be affecting their eyesight. The refraction procedure (eyesight testing for prescription vision acuity) done during the visit is typically not covered by Medical Insurance.
Vision Insurance is separate from Medical Insurance coverage. Vision Insurance may either be included in an employee’s benefit package or is purchased directly by the employee via payroll deduction. Vision Insurance is meant to cover simple, routine vision exams including a basic refraction procedure (eyesight testing for prescription vision acuity) and a basic eye health screening. Examination fee reimbursements are significantly discounted to eye care providers due to the non-medical nature of this routine exam service. Vision Insurance coverages for glasses and contact lenses vary significantly and can be very confusing to patients as well as to providers due to the vast amount of optical product options. We will help sort through these optical situations for our patients using Vision Insurance.
Family Vision Care's Policy on Billing Insurance Plans
When a patient sees our doctor for an office visit or a comprehensive exam for a medical eye problem or has existing medical eye conditions that requires monitoring by the doctor, our practice will bill the patient’s charges to Medical Insurance as the primary payer and then to Vision Insurance as the secondary payer (if applicable and allowable for coordination of benefits). Co-pays and refraction fees will be collected in most cases at the time of the professional service. We will do all of the insurance billing. We remind our patients however, that their Medical Insurance may have certain deductibles which are usually unknown to our insurance coordinator as to whether they have been met. Any remaining balance owed after insurance payments have been received by our practice will become the obligation of the patient.
Family Vision Care participates with most major vision and medical insurance plans including:
- BCBS (PRO ONLY)
- Tricare (STANDARD)
- United Health
- Always Vision
- Compbenefits (VCP)
- Superior Vision
If your plan is not listed here, please call our practice, we may still be a provider! Our staff will help you maximize your plan benefits and limit your out of pocket expenses if we are not.
For patients who have no vision and/or medical eye care insurance coverage, Family Vision Care offers a Time of Service 10% Cash Discount on professional services and most optical products. Please call and speak with a patient services staff member.
Out of Insurance Network Situation
You can still receive the great care, products and service from Family Vision Care by taking advantage of our time of service cash discounts on exams and optical products. We will provide an itemized statement for you to submit to the insurance company for reimbursement to you.