Vision vs. Medical Insurance

Why do you ask for both my medical and vision insurance?

Many times patients present to me with complaints of vision AND medical. Vision insurance covers a routine eye exam with a refractive diagnosis. Your medical insurance covers anything with a medical diagnosis.

What is considered “medical” by my insurance?

Any subjective complaints that range from dry eyes to visual disturbances such as flashes or floaters. Blurred vision that can be corrected by glasses or contacts, and is not a medical diagnosis unless the blurred vision is due to a medical eye diagnosis.

Also, sometimes you may not have any complaints but, I may find something that either requires treatment, monitoring, or referral to a specialist. Approximately 3 million Americans have glaucoma, and another 50% have it and are unaware they have it.

Glaucoma can cause blindness and I need to make sure none of my patients lose their vision. Some people fall into a “suspect” status and require monitoring. This is a medical diagnosis. My office has all the advanced technology which is available to doctors today, in order to identify these individuals and monitor and/or treat them if glaucoma is found.

Diabetes is another big one. Most patients with a diagnosis of diabetes are found after 10 years to have developed leaky blood vessels. The eye is the only part of the body where we can see this leakage. I can communicate with your treating physician to adjust your medications to assure you do not lose vision.

There are a host of diseases that have no symptoms which are imperative that I examine for. I examine all patients very carefully. I know how important vision is and what the detriment of losing vision can cause. Most patients who lose vision do so due to lack of routine care.

As a profession, eye doctors have previously done a poor job of educating the population what we actually do. My background and years dealing with ocular diseases have put me in a position to catch early signs diseases to keep you seeing. Any condition that is not refractive (myopia, hyperopia, presbyopia) are billed and coded through your medical plan.

Only refractive diagnosis can be billed through your vision plan. It’s important to keep this in mind when electing to purchase vision insurance.