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Insurance Explanation

Proper Use and Billing of “Vision Plan” Insurance: VSP and others

Proper Use and Billing of Vision Plan Insurance: VSP and others Vision plan insurance can be used for a routine eye exam to check eyeglasses and contact lens prescriptions. Some basic screening type tests are performed for eye health also.

A routine eye exam using vision insurance does not cover any medical eye issues. So, if you have red eyes, dry eyes, allergy eyes, new onset of floaters, infections, glaucoma, crossed eyes, double vision, management of any eye diseases, you MUST use your regular medical insurance to cover these visits. This is no different than a visit to your family doctor, or pediatrician. You will pay your co-payment for each visit as usual. If you do not have vision insurance in addition to your health insurance, and want to have your eyeglass prescription checked, there will be a small additional out of pocket fee for this. Occasionally the medical insurance will reimburse you for this part as well. There is also a fee for checking contact lenses.

If you are having a routine exam that is going to be billed to your vision plan, and need to have a medical eye condition evaluated and treated, you will need to return for these services on another day, and that exam will be billed to your regular medical health insurance.

These are the rules of the vision plans and the health insurance plans, not of our office.