Insurance Info

Understanding Medical vs. Vision Insurance
One of the most common questions we hear from patients is: “What’s the difference between medical insurance and vision insurance?” Here’s a quick overview to help you understand how each type of coverage works.

Vision Insurance – Focused on Routine Eye Care
Vision insurance is designed to help with the cost of routine eye care and eyewear. This typically includes:

1. 1. Comprehensive vision exams for glasses or contact lenses

2. 2. Prescription updates for eyewear

3. 3. Discounts or allowances toward glasses and contact lenses

4. 4. Sometimes, coverage for lens coatings and upgrades

Vision insurance does not usually cover the diagnosis or treatment of medical eye conditions. Think of it like a “wellness plan” for your eyes, helping you maintain healthy vision and see clearly day-to-day.

Medical Insurance – Covers Eye Health Conditions
Medical insurance applies when your visit involves an eye health problem or when a systemic health condition affects your eyes. Examples include:

1. 1. Eye diseases like glaucoma, macular degeneration, or cataracts

2. 2. Eye injuries or infections

3. 3. Diabetic eye exams

4. 4. Dry eye evaluations and treatments

5. 5. Surgeries and advanced procedures

If your appointment is related to a medical diagnosis, your medical insurance will be billed, even if the issue is discovered during a routine exam.

Which One Will We Bill?

1. 1. If you are here for a routine vision exam and eyewear, we’ll use your vision insurance.

2. 2. If you have symptoms such as eye pain, redness, sudden vision changes, or we detect a medical condition during your exam, we’ll bill your medical insurance for the visit.

3. 3. Sometimes, both types of insurance can be used, medical for the health exam and vision for your eyewear.

4. 4. Tip: To make the most of your benefits, be sure to bring both your medical and vision insurance cards to your appointment. Our team can help you determine which coverage applies and answer any questions you have.
   
   

Out of Network: Higher Cost for Patient

Not Contracted: Cannot See