There are two types of insurance that may help pay for your eye care services and
products. You may have both types:
1. Vision care plan (such as VSP, EyeMed, and others)
2. Medical insurance (such as Blue Cross/Blue Shield, Medicare, and others).
I have read and accept these policies.
- Vision care plans only cover routine vision wellness exams and may provide
an allowance towards eyeglasses and contact lenses. Vision plans do not
cover medical eye care (the diagnosis, management or treatment of eye health
- Medical insurance (or health insurance) must be used for medical eye care.
- A vision wellness exam is defined when the only diagnosis is refractive in
nature (nearsightedness or astigmatism, for example). A medical eye exam is
when the diagnosis is anything other than refractive (glaucoma, cataract, dry
eye syndrome, diabetes, hypertension, high cholesterol, and many others).
- Medical insurance must be used if you have an eye health problem or
systemic health problem that has possible ocular complications. This includes
medications that have ocular side effects. Your doctor will determine if these
conditions apply to you, but some are determined by your case history.
- If you have both types of insurance plans it may be necessary for us to bill
some services to one plan and some services to the other. We will follow a
procedure called coordination of benefits to do this properly and to minimize
your out-of-pocket expense.
- We will bill your vision plan or medical insurance for services if we are a
participating provider for that company. If we are not a provider, you may
submit your own claim for reimbursement of the fees you pay. We will try to
obtain authorization in advance for your insurance benefits so we can tell you
what is covered. If some fees are not paid by your insurance, we will charge
you for them, such as deductibles, co-pays or non-covered services as
allowed by the insurance contract.