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Seeing Your Eye Doctor Through Your Health vs. Vision Insurance

Health vs. Vision InsuranceUnderstandably, many patients have questions regarding the differences between health insurance and vision insurance/plans. Dr. Linda Vu, a leading ophthalmologist in Monterey Park, discusses the differences between the two in this blog post.

Health Insurance vs. Vision Plan

Health insurance plans pay for medical services for health conditions and treatments including eye injuries, infections and diseases. Examples of eye conditions that can be covered by health insurance are corneal disorders, diabetic retinopathy, cataracts and glaucoma. Vision insurance, commonly referred to as a vision plan, is supplemental to regular health insurance and can be used to pay the full or partial cost (depending on the specific plan) of routine eye exams, prescription eye glass frames, lenses, and contact lenses. Some vision plans also offer discount prices for elective vision correction procedures including LASIK.

Routine Eye Exam vs. Medical Eye Exam

Eye exams are categorized as either routine or medical. The distinction is important as the nature of the eye exam determines whether it is covered by health or vision insurance. Routine eye exams are considered to be a part of your regular eye care and can be covered by vision plans, while medical eye exams are covered by health insurance. The type of eye exam you have is determined by the reason of your visit as well as your diagnosis. For instance, if you visit your eye doctor for a routine eye exam but an underlying problem such as cataracts or glaucoma is detected, your exam may be considered to be medical and thus your health insurance may be billed.

Understanding Your Coverage

Keep in mind that policies and plans vary among insurance companies. Before seeking treatment, it is imperative you understand your plan’s coverage. When choosing an insurance plan, be sure your policy covers the necessary services and treatments you and your family seek.

At Linda Vision, Dr. Vu and our knowledgeable staff have helped thousands of patients understand their vision and health insurance plans. We are more than happy to help you understand your insurance coverage.

To speak to a member of our team, please call (626) 382-2020 today.

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