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What are Vision Plans?

What are Vision Plans?

A vision plan or policy is not the same as medical health insurance. Vision plans provide limited services for eye health wellness exams. It is a  benefit designed to provide routine eye care, prescription eyewear and / or contact lenses at a reduced cost. These plans are NOT insurances but solely arranged discount programs. As such, there are associated charges and co-pays dictated by the plan and are the responsibility of the patient.

How Do Medical Insurances work for Eye Health Issues?

Medical insurances, (such as Cigna, Aetna, United, Oxford, Horizon, BCBS....) Medical  health insurance plans are utilized by the eye - optometric and ophthalmic physician(s) when there are specific medical related conditions of eye health such as cataracts, glaucoma, cornea, retina, or emergency eye problems. As well, systemic concerns that can effect the eyes such as diabetes, high blood pressure, thyroid disease, blood disorders, cardio vascular disease, rhuemtological disorders and so forth would be billed to the medical insurance carrier NOT the vision plan. Vision plans do not cover ophthalmic testing and treatment of ocular-systemic concerns.

As a note, in some cases medical insurances do provide a basic eye wellness exam similar to the limited level of vision plans. The eye wellness exams provided by the medical insurer does not cover - medical concerns of the eye as discussed above.

What are Deductibles and Co-pays?

Vision plans are discount only eye wellness programs offering a reduced rate for materials and exams. Based on the plan programs, the patient would be fully responsible for the co-pays and charges dictated by the their plan. Our office will review the program with you at the time of visit but it would be beneficial and will expedite the visit if the patient supplies the plan program to our staff at the time of making their appointment. This will allow our office to search for an authorization and plan benefits prior to your visit.

As of January 1st, 2017, medical insurance companies, incorporation with the Dept of Banking and Insurances, AMA, Academy of Ophthalmology and American Optometric Assocation, are now encouraging offices to collect deductibles at the time of visit. As such, please supply your medical insurance information to our staff at the time of making an appointment. This will allows us to seek the appropriate coverage information for you prior to your visit and determine if any deductible exist on your medical policy.

Where can I get vision plans?

Group vision plans can be obtained through your company, association, school district, etc., or through a government program such as Medicare or Medicaid.

Also, as an individual, you have the option of purchasing your own vision benefit plan.

Vision plans are often a value-added benefit included in indemnity health insurance plans, health maintenance organization (HMO) plans and plans offered by preferred provider organizations (PPOs):

  • Indemnity health insurance is traditional insurance, which allows policyholders to access medical providers of their choice.
  • An HMO is a group of healthcare professionals - doctors, laboratories, hospitals and the like - employed to provide health care services to plan members at discounted rates. Usually, health plan members are required to access health care only from HMO providers.
  • A PPO is a network of healthcare professionals organized to provide healthcare services to plan members at a fixed rate below "retail" prices. Plan members may opt to access out-of-network providers, but usually at a greater cost.

What kinds of vision plans plans are available?

Vision plans typically comes in the form of either a vision benefits package or a discount vision plan.

Typically, a vision benefits package provides enrollees eye care services in exchange for an annual premium or membership fee, a yearly deductible (a dollar amount) for each enrolled member and a co-pay (a smaller dollar amount) each time a member accesses a service.

A discount vision plan provides eye care at fixed discounted rates after an annual premium or membership fee and a deductible are paid.

Both kinds of vision plans can be custom-designed to meet the different requirements of a wide range of customers, including school districts, unions, and big and small companies.

What do vision plans cover?

Vision plans generally covers the following services and products:

  • Annual eye examinations
  • Eyeglass frames
  • Eyeglass lenses
  • Contact lenses
  • LASIK and PRK vision correction at discounted rates

Generally, services acquired from network providers are cheaper than services from out-of-network providers.

What are my payment options?

Typically, if group vision plans are available from your employer, you pay for it through payroll deductions or flexible spending accounts (FSAs).

An FSA, sometimes called a cafeteria plan, allows an employee to use pre-tax dollars to purchase selected health benefits such as vision plans. You save money because you receive the full benefit of income that has been set aside for health costs, making it not subject to or reduced by taxation.

If you purchase an individual vision plans plan because your employer doesn't offer a group plan (or because you are self-employed), you can expect to be billed monthly or annually.

For more information on vision plans, visit All About Vision®.

CareCredit

As a service to our patients, we are pleased to offer the CareCredit card, the nation’s leading patient payment program. CareCredit lets you begin your procedure immediately—then pay for it over time with low monthly payments that are easy to fit into your monthly budget. So, you can begin your vision care today and conveniently pay with low, monthly payments. CareCredit offers a comprehensive range of No Interest and Extended Payment Plans for procedure fees from $1 to over $25,000

Go to link to learn more and apply: