Understanding Medical Insurance Vs. Vision Insurance
Understanding Medical Insurance Vs. Vision Insurance
At Harmon Ophthalmology, P.C. we know insurance can be confusing — especially when it comes to eye care. Here’s a simple guide to help you understand the difference between medical insurance and vision insurance, and how it applies to your care with us.
What does medical insurance cover at the eye doctor?
Medical insurance is designed to cover the diagnosis and treatment of eye health problems.
At our office, we bill through your medical insurance for these services.
This includes:
- Eye diseases such as glaucoma, cataracts, macular degeneration, or diabetic retinopathy, etc.
- Eye injuries
- Eye infections
- Medically necessary procedures and surgeries
- If you come in because of a family history of a medical condition (such as glaucoma or macular degeneration, etc.), your visit will also be billed under medical insurance since it requires a medical evaluation to check for or monitor the condition.
- If you have symptoms like eye pain, vision loss, sudden changes in vision, or if you’ve been diagnosed with an eye condition, your medical insurance typically covers these evaluations and treatments.
What does vision insurance cover at the eye doctor?
Vision insurance, on the other hand, is primarily for routine eye care, including:
- Annual vision exams (checking for prescription updates)
- Glasses or contact lens fittings
- Discounts or allowances for eyewear
The ONLY vision insurance we accept at our office is VSP (Vision Service Plan).
If you have VSP, we can provide your routine eye exam and help with your glasses or contacts benefits.
Important Note:
If you have BOTH medical and vision insurance, we’ll help you determine which to use based on the reason for your visit.
For example:
A routine annual exam for glasses may fall under your vision plan (VSP).
However, if you’re being evaluated or treated for a medical eye problem, we’ll bill your medical insurance.