With the changes in insurance benefits each year, this is certainly a legitimate question to ask. And, BEFORE the end of the year, now is the time to know if you have maximized your insurance benefits.
Government insurances such as Medicare or Medicaid cover an eye exam every year. Medicaid is limited to one eye exam per year. Medicare will cover an exam more than once a year if needed. There is a portion of the examination that is not covered by Medicare. For this part, the patient is responsible. Medicare covers 80% of all allowed services. If there is a second insurance, the remaining 20% may be covered by that plan. It is the patient’s responsibility to inform the doctor’s office if there is more than one insurance to be considered. Take your insurance cards and proper I.D. to your doctor visits.
Medicaid is different from Medicare. The annual examination is only covered once per year but you may be eligible for visits related to problem with your eyes. A co-pay may also be required. Some Medicaid plans also only cover glasses for those under age 21 while the others do not have an age requirement. It is best to check your plan before you scheduling to see if you are eligible for vision or medical benefits.
Private insurances such as Blue-Cross, Aetna, Cigna, United Healthcare, and others have specific benefits that may allow either vision or medical benefits for eye care. Many private insurance companies are affiliated with ‘vision plans’ (such as VSP, Vision Care Plan, Spectera, Eye Med, NVA, or other affiliates). Sometimes, the office may have a difficult time determining this, but you may check with your human resource department and they can inform you if you have a separate vision insurance.
My staff is trained to explain your benefits if you need additional help, but it is best if you know ahead of coming to your appointment. This can save time and keep your appointment from being delayed. I hope this article will be helpful for you when you schedule your next eye exam. REMEMBER TO USE YOUR BENEFITS BEFORE THE END OF THE YEAR. USE IT…, or LOSE IT!!!
If you need an eye care provider, visit EnVision Eye Care for your next exam. We accept Medicare, Medicaid, Tricare, and many other insurances. If you do not have insurance, ask about our “SEE CLEARLY YEARLY VISION BENEFIT PLAN.”
321 W. Montgomery
(near Hunter Golf Course)
For appointments, call