Today's health care environment has become more confusing and complex. Understanding your health insurance and vision benefit is not as easy as it once was. Our practice has provided this information to untangle and clarify many misconceptions about third party care and your vision.
It is important for all patients to understand a fundamental principle of the third party mechanism. Unless your provider (doctor or health care facility) specifically takes assignment of benefits, the patient is ultimately responsible for any non-covered services and their charges. The insurance relationship is between the patient and the insurance company not between the patient and the provider.
Many common vision insurance programs only cover the vision part of the overall eye health examination. There are two distinct and important elements to every visit to our practice. First, the most important aspect of your visit today is to insure quality of life by providing you with a comprehensive, thorough medical examination of your visual system. Many eye diseases that affect your vision have little or no symptoms until the problem has become sight-threatening. Routine eye health examinations are critical to prevent debilitating eye disease. Secondly, each comprehensive medical eye exam will include a vision component to analyze and prescribe, if necessary, eyewear or contact lenses to correct your vision.
It may be necessary for your doctor to perform additional special testing to insure the overall systemic health of your eyes. Some of this additional testing may not be covered as part of your vision benefit. Payment for these additional special tests usually can be billed to your medical insurance. The good news for patients without vision benefits is that many times your eye exam and/or extra testing may be billed to your health insurance if you have a medical problem included in your complaint.
Insurance Plans Accepted (a partial list):
- VSP
- UHC, CVC
- Eyemed, Ecpa
- Medicare
- Blue Cross Blue Shield
- Flora Health
- First Health
- Unicare
- Medical Mutual
- Many, many other health and vision plans - just ask at your appointment.
Our insurance coordinator is available to answer any questions. Due to the large number of different Vision Insurance Benefit Programs, it is impossible to know the specific details and reimbursement policies of each. If our doctors do not participate in your Vision Benefit Program, we will be happy to provide you all the necessary forms and documentation for you to submit to the carrier for reimbursement.
Any vision or medical benefits not covered by insurance is the responsibility of the patient.
Thank you for your understanding and patience.
