The Difference between Health Insurance and Vision Plans
The cost of routine and medically necessary eye care and prescription eye wear can be of real concern, especially for large families. Often your health insurance and vision plan can lower these expenses. The difference between health insurance and vision plans is a source of frequent misunderstanding in eye care, however.
A vision plan (often sold, or included, as an additional benefit to your health insurance plan) is not health insurance for your eyes. Your regular health insurance covers you against expenses arising from eye problems other than those corrected by glasses and contacts, eye injuries and eye disease, and has no set frequency or annual limitation. A vision plan on the other hand is a wellness benefit that provides an annual vision exam when there are no medical symptoms, diagnoses or conditions affecting the vision or health of the eyes. It will typically provide some coverage towards the purchase of glasses or contacts if necessary to correct vision.
Examples of common medical conditions that necessitate eye-care not covered by vision plans include:
- Symptoms such as eye pain, sensitivity, redness, itching, discharge, flashes, floaters, etc.
- Eye Allergies, Dry Eye, Eyelid Bumps, Styes, Droopy Eyelids
- Diabetes or Pre-Diabetes
- Certain high risk medications such as Plaquenil or Hydroxychloroquine
- Lazy Eye, Strabismus, Amblyopia or Blind in One Eye
- Macular Degeneration
- Elevated Eye Pressure
- Keratoconus or highly irregular Astigmatism
- Pathological / Degenerative Myopia – i.e. A glasses prescription exceeding -6.00
- A history of any eye surgery other than LASIK or PRK – i.e. Cataract, Pterygium, Glaucoma, Radial Keratotomy (RK), Retinal Surgery, Intraocular Injection, etc.
We strive to have all our patient’s health insurance and vision plan information verified before their appointment in order to keep our patient wait times to a minimum, and to eliminate the need for us to bill our patients at a later date because a vision plan denied services or because of an unmet deductible. The world of insurance is constantly changing, but our staff is always available to answer questions.
Health Insurance Plans we accept:
- Blue Cross Blue Shield
- Physicians Health Plan
- TML MultiState
- United Health Care
- Golden Rule
Vision Plans we accept:
- TML MultiState
- Blue View Vision
- Eye Med
- Davis Vision
- Humana Specialty Benefits
- Superior Vision