Vision Benefits and Medical Insurance: What's the Difference?

We have patients that have both VISION BENEFITS and MEDICAL INSURANCE. They are very different in terms of the services they cover and it's important for our patients to understand these differences. 

We are in-network providers for medical insurance and we are out-of-network for most major vision benefit plans (Davis, EyeMed, VSP, Spectera, Blue View, Superior). This means that even though we do not have a contract with your vision plan, you can still see us and use your vision plan benefits! As an open-access out-of-network office, we are still available to see patient's that carry most major vision benefit plans. Payment is due at the time of service and we will file the out-of-network claim for you. You will receive a reimbursement* check from your vision benefit plan in ~4 weeks!

Medical Insurance (United Healthcare, MVP, etc.) covers office visits and/or procedures for medical conditions that affect the eyes. When a medical eye or health condition is present (such as diabetes, cataracts, dry eye, floaters, eye emergencies, etc) we can file the visit with your major medical insurance and the copays and deductibles for that insurance will apply as well as any non-covered service fees.

Vision Benefit Plans  (Davis, EyeMed, VSP, Spectera, etc.) cover an office visit to determine the prescription for your glasses and/or contact lenses and a general eye health check. It also provides discounts on the materials you purchase including frames, lenses and/or contact lenses. 

We make every effort to be on most major medical insurance carriers for your convenience and we will file those claims for you. 

*Rebates are determined by your vision plan, we can give you an estimate on what they will reimburse you - but ultimately it is up to your vision plan to determine how much you will receive in your reimbursement.

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Don't see your insurance company listed?

In the event that we are not in network for your insurance company, we would be happy to provide you with an itemized receipt so that you may file with your carrier for reimbursement. If you have any questions regarding this topic, please let us know.