Medical insurance and vision plans are very different in terms of the services they cover and it is important for our patients to know those differences.
Vision plans are designed for routine wellness eye exam services to determine a prescription for glasses/contacts and materials but are not intended for medical conditions or diagnoses and treatment.
Medical insurance are designed for medical eye exam services and does not cover the routine refraction portion of the exam used to determine the glasses or contact lens prescription.
Vision plans (i.e. VSP, Eyemed) allow for wellness eye exam but if you have a medical eye concern (i.e. burning or tearing of eyes, floaters, red eyes, etc.) or if medical eye conditions are determined to affect your vision and/or exam (i.e. diabetes, autoimmune diseases, glaucoma/glaucoma suspect, cataracts, dry eye, eye infections, retinal conditions, high risk medications, etc.) then it is necessary to file the visit and any additional necessary eye tests performed with your major medical insurance carrier (i.e. BCBS, Aetna, Cigna, Humana, Medicare, Tricare, United Healthcare).
Insurance carriers set these rules and our office is required to follow them.