One of the most common issues that comes up in eye care practices is the difference between health insurance and vision insurance. It can be confusing, but I believe this will simplify the matter.
Health insurance plans will cover office visits with your eye doctor, as long as there is a “medical eye problem.” For example, if a person has cataracts, diabetes, eye pain, glaucoma or any other eye health problem, the major medical health insurance plan will cover the office visit at the optometrist’s office just the same as your physician’s office.
Consider this, if you hurt your big thumb, you go to your physician for treatment. The physician’s office doesn’t ask if you have hand insurance. This may sound silly, but the same goes for the eyes. If you have an eye problem, you don’t need “eye” insurance to get treatment.
As for “vision insurance,” these plans fully or partially cover basic eye exams with glasses and/or contact lenses. Vision insurances usually do not cover office visits related to eye problems unrelated to glasses and contact lenses.
This is an important thing to know because someone should never put off getting an eye problem treated just because he or she doesn’t have vision insurance. For that matter, no one should ever put off treatment for an eye problem, even if he or she has no insurance at all. The eye doctor is there to treat, protect and preserve the vision and eye health of all people, regardless of the arrangement for payment.