Have insurance questions? Confused by all the insurance and ophthalmology lingo you encounter? Let’s start by helping you figure out which insurance will be used for your exam. Look below, and see what category fits best for you for this visit. Is the reason for your visit medical related or vision related?
Medical Related Visits
Insurance that covers Medical related visits include Medicare, Cigna, Humana, UHC, BCBS,Tricare, Banner and involve the following complaints:
- Dry eyes
- Itchy eyes
- Red eyes
- Macular degeneration
- Droopy eyelids
- Sudden decrease in vision
- Flashes or floaters
*Co-pay and/or deductible will apply as well as refraction and/or contact lens evaluation fees.
Vision Related Visits
Insurance that covers Vision related visits include VSP, EyeMed and involve the following complaints:
- New glasses prescription
- New contact lens prescription
*Co-pay will apply; NO MEDICAL TESTING beyond a routine exam can be done on the same day if using a vision discount plan. If you have medical issues that need further treatment, you will have to use medical insurance for the next visit.
Refraction is the “better one or two” test the doctor performs to calculate a glasses prescription for you. This is not required on medical exams; however, we are unable to tell if your glasses prescription has changed or issue a new prescription without performing this test. VISION Insurances DO cover the cost of this test. MEDICAL Insurances DO NOT usually cover the cost of this test but you may choose to have this done at your medical visit for a separate nominal fee.
Contact Lens Evaluation
Because contact lenses are medical devices, it is imperative every lens be assessed to ensure the best fit. Ill-fitting lenses, or lenses that do not allow enough oxygen to the cornea, increase a patient’s chance to suffer an infection that may lead to permanent vision loss. For patient safety, we do not release updated contact lens prescriptions without an evaluation. Vision plans may have some benefits for contact lens evaluations, whereas medical insurances do not.
If you still have questions regarding insurance, please contact us and we will be happy to answer your questions.