Anonymous
04/01/2015 08:30
Subject: Does med insurance cover the eye doctor? or was I just fleeced?
Anonymous wrote:I've dealt with a lot of vision appointments recently for some vision loss.
If it helps: Your vision/eyes can be an early indicator for underlying medical issues — diabetes, heart disease, torn retina, etc. If you discover you have one of these — or when further testing is needed to determine if that's the case — then it becomes a medical issue covered by medical insurance to treat THAT issue.
Routine eye exams under vision insurance are two part — where they look for any indicators of a possible medical issue and the 'refraction' portion where they improve vision with a prescription. Even if you're being treated for an above medical issue, this exam is still put under vision insurance. It's also worth noting, if you try to skip to just the refraction portion it may not be considered a full annual exam covered required by your vision insurance (I got confused once and did this when I'd been to a specialist the same week).
Out of frustration, personally I did some legwork to find one that took both my insurances.
By "THAT issue" I meant the both the vision ramifications of that medical issue, if that's not clear.
Anonymous
04/01/2015 08:29
Subject: Does med insurance cover the eye doctor? or was I just fleeced?
I've dealt with a lot of vision appointments recently for some vision loss.
If it helps: Your vision/eyes can be an early indicator for underlying medical issues — diabetes, heart disease, torn retina, etc. If you discover you have one of these — or when further testing is needed to determine if that's the case — then it becomes a medical issue covered by medical insurance to treat THAT issue.
Routine eye exams under vision insurance are two part — where they look for any indicators of a possible medical issue and the 'refraction' portion where they improve vision with a prescription. Even if you're being treated for an above medical issue, this exam is still put under vision insurance. It's also worth noting, if you try to skip to just the refraction portion it may not be considered a full annual exam covered required by your vision insurance (I got confused once and did this when I'd been to a specialist the same week).
Out of frustration, personally I did some legwork to find one that took both my insurances.
If it helps: Your vision/eyes can be an early indicator for underlying medical issues — diabetes, heart disease, torn retina, etc. If you discover you have one of these — or when further testing is needed to determine if that's the case — then it becomes a medical issue covered by medical insurance to treat THAT issue.
Routine eye exams under vision insurance are two part — where they look for any indicators of a possible medical issue and the 'refraction' portion where they improve vision with a prescription. Even if you're being treated for an above medical issue, this exam is still put under vision insurance. It's also worth noting, if you try to skip to just the refraction portion it may not be considered a full annual exam covered required by your vision insurance (I got confused once and did this when I'd been to a specialist the same week).
Out of frustration, personally I did some legwork to find one that took both my insurances.
Anonymous
04/01/2015 07:09
Subject: Re:Does med insurance cover the eye doctor? or was I just fleeced?
OP, this is no help to you now but others have made helpful suggestions.
With all of the changes that have taken place and are continuing to take place with the health insurance marketplace, I routinely call any medical provider to find out whether a particular procedure or visit is covered by my health insurance. I do this even if one would expect the provider to check it out themselves like happens with procedures like a colonoscopy where I call the insurance company to find out if it needs to be pre-approved by the insurance company.
I would rather be cautious than to be surprised with a large bill after it is all done.
With all of the changes that have taken place and are continuing to take place with the health insurance marketplace, I routinely call any medical provider to find out whether a particular procedure or visit is covered by my health insurance. I do this even if one would expect the provider to check it out themselves like happens with procedures like a colonoscopy where I call the insurance company to find out if it needs to be pre-approved by the insurance company.
I would rather be cautious than to be surprised with a large bill after it is all done.
Anonymous
04/01/2015 07:03
Subject: Does med insurance cover the eye doctor? or was I just fleeced?
Medical insurance doesn't cover my regular eye appts. Vision insurance might, but my ophthalmologist doesn't take my plan. I pay out of pocket.
Anonymous
04/01/2015 06:59
Subject: Re:Does med insurance cover the eye doctor? or was I just fleeced?
My vision insurance covers normal exams. Sounds like your doctor just didn't take your insurance for most of what you needed? Maybe you could submit the bill yourself to your vision plan and try to see if you can get some $ back for out of network coverage, depending on your plan.
As far as recommendations, if this is just for a normal exam, I just go to My Eye Doctor, which is a chain but seems fine for mundane things and they take tons of insurance plans.
As far as recommendations, if this is just for a normal exam, I just go to My Eye Doctor, which is a chain but seems fine for mundane things and they take tons of insurance plans.
Anonymous
04/01/2015 06:10
Subject: Does med insurance cover the eye doctor? or was I just fleeced?
Checking your last appointment for the amount charged won't be helpful. CALL your insurance co ( phone # should be on the back of the card) and find out if you have vision coverage.