Hello and welcome back to my blog! I’m Dr. Whitney Welder, OD, here to answer all of your eye exam related questions. Today’s question is “What’s the difference between my medical insurance vs my vision insurance?”
Keep in mind, insurance is often as unique as the patient themselves, based on individual benefits and needs. For this reason, this post is meant to provide a general overview of what insurance may provide a benefit for, but that may not necessarily be your individual specific plan or patient care needs. At Prairie Vision Center, both medical and vision insurance are accepted, and at different times both may be accepted for the same patient.
Let’s start with what vision insurance may typically be used for. Vision insurance will generally provide a benefit for a routine, comprehensive eye exam, where there are minimal other medical issues present. Vision insurance will often provide a benefit for glasses or contact lenses every 1-2 years depending on the plan. Vision insurance plans vary greatly in benefits depending on who the insurance is through and what plan was selected.
Medical insurance often provides benefits if there is a medical diagnosis present. Some of these diagnoses are diseases like macular degeneration or glaucoma which often require several routine tests such as a visual field or OCT to monitor the condition. Medical diagnoses would also include reasons you may see your eye doctor emergently such as getting something in your eye, sudden flashes or floaters, or a pink or red eye. (As a sidenote, my next blog post will detail more on when to see an optometrist emergently) Essentially, outside of a routine exam, generally medical insurance is billed.
Please note, I am an optometrist, but I’m not necessarily your optometrist. Any advice in the above blog post is not meant to be taken as personalized medical advice. Come see me or one of the great eye doctors at Prairie Vision Center for more personalized care.
If you have a question for the blog to answer, please email prairievisioncenter@gmail.com or call 701-642-4090.