Do you know the difference between medical insurance and vision insurance?
Insurance can be frustrating — in-network, out-of-network, deductibles, coinsurances — all the lingo can become quite confusing.
Here is a quick breakdown of the differences to help simplify insurance for you:
MEDICAL INSURANCE
In the field of optometry, regular medical health insurance protects you from unexpected costs for eye injury or disease. Optometrists are required by law to file certain exams and conditions as medical, even if you do have an active vision insurance policy. Some common conditions in which we must bill patients as medical claims includes floaters, vision loss, dry eyes, infections, allergies, cataracts, glaucoma, and diabetes.
VISION INSURANCE
Vision insurance provides an added wellness benefit at a reduced rate for healthy eye exams, including routine eye care, prescription eyewear, and contact lenses.
Some examples of in-network vision plans that we accept include VSP, Alwayscare and Allwell/Envolve.
FREQUENTLY-ASKED-QUESTIONS
Can I use my medical insurance and vision insurance for a joint exam on the same day?
No. By law, we cannot bill two different types of insurances in one day. There are two alternatives.
First, we can always schedule your medical and vision visits on separate days, allowing us to bill your insurance 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 a the time of your visit) and paying the additional flat rate for a refraction ($20).
Why is insurance so complicated?
We don’t make the rules, we just follow them! You can call the phone number on the back of your 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.