What is the difference between medical insurance and routine vision eye exams?

We can bill medical insurances for any examinations and treatments for visits that have a medical diagnosis. Examples would be eye infections, dry eye syndrome, ocular allergies, and systemic conditions such as diabetes and high blood pressure. Conversely, vision plans do not cover these types of visits. We can submit claims directly to medical plans that we participate with. A routine vision checkup is considered one annual visit for refraction (eyeglasses prescription) and an eye health overview. For these services and eyewear materials, we submit directly to either VSP or Eyemed. It is important to note that all medical insurance providers do not provide routine vision coverage (refraction). The ones that do have it as an additional benefit carved out or subcontracted to a vision plan company. So in order to provide our patients with the best service possible, we need to have a copy of both their medical insurance and their vision plan cards.

What is the importance of “verifying my benefits”?

We do our best to contact your insurance provider(s) to find out if your coverage is active, what services are covered if your deductible has been met, and what co-payments you will be charged. We are better able to estimate the charges that you will be responsible for by verifying this information prior to your appointment.