Vision Plan vs Medical Insurance
What is the difference between a vision plan and medical insurance?
It can be tricky to decipher the difference between a vision plan and medical insurance. However, we will try to break it down so you can use your benefits correctly.
A vision plan only covers a routine wellness exam to determine glasses or contact lens prescription. It does not cover any specific concern that you may have about your eyes. We will bring you back for an office visit under your medical insurance to address any eye concerns you may have or we may switch your comprehensive eye exam to medical if you have an urgent problem that needs to be treated. We will often wait for conditions to stabilize before we perform a routine vision exam.
Medical insurance covers any problems or concerns you may be having with your eyes. This includes dryness, allergies, sudden changes to vision, flashes, or any other symptoms you may be having. Patients that have a specific concern about the eye will utilize their medical insurance. If you have any questions, please call our office at 303-404-2020 and we would be happy to talk you through the difference.
You are not listed as a provider with my vision plan, but I would still like to be seen at your office. What options do I have?
We can bill your medical insurance for an eye exam if a medical problem is detected during the exam. However, medical insurance does not cover a refraction (the portion of the exam to determine your glasses and contact lens prescription) so this portion will be paid out of pocket.
Another option that our office can provide to you is the Anagram service. We are open access providers which allows us to see you for your comprehensive exam if you have out-of-network benefits through your vision plan. Anagram will allow us to check your eligibility for out-of-network benefits and determine the rebate your vision plan will provide to you. Out-of-network does not mean out of benefits.
Why do I have a copay?
Your medical insurance card will list any copays you may have for an office visit on the front of your card. This is the contract that has been set up between you and the insurance company. We will collect the Specialist copay at the time of service.