Medical Vs. Vision Insurance
What insurance will cover what: Vision Vs Medical
Vision and Medical insurance are both accepted at Kreda Eye Center, however they often provide coverage for different services. Because of the staggering diversity and complexity of insurance plans, we would like to simplify the process by providing you with specific information regarding your plan. Please contact the office directly to utilize this service.
Vision plans are primarily for routine eye exams, glasses, and contacts only. A routine eye exam is for patients that have no medical eye problems or known eye health issues. The goal of a routine eye exam is to make sure that your eyes are perfectly healthy and to discover unknown problems.
The good news is that your Medical Insurance will cover your eye exam when there is an eye-related medical problem, such as, cataracts, dry eyes, complications from diabetes or high blood pressure (among many others). You do not need a vision benefits rider on your medical insurance or a Vision Plan to be covered. In these cases, your Medical Insurance will cover your eye exam even though a Vision Plan may also be in effect. Your Medical Insurance co-pays and deductibles prevail and must be paid at the time of your exam. More Good News!: If we do file the exam with your medical insurance, you can still use your Vision Plan benefits towards the purchase of glasses or contact lenses based on your plan’s allowances.
So…if you tell us you have an eye problem such as headaches, redness, irritation, burning or tearing of the eyes, your eye exam is covered by medical insurance, you don’t need a vision plan. See the list below for some common medical presenting conditions
Vision Plans Cover Refractive Care: i.e. what eyeglasses or contact lenses correct.
They include these common vision conditions:
367.40 Presbyopia, aka can’t see up close (needs reading glasses).
Medical Insurance Covers Conditions That Can Affect the Health of Your Eyes:
Some Common Presenting Medical Complaints and Conditions:
379.91 Eye Pain, Eye Strain
371.82 Contact Lens Related Eye Health Problems
372.22 Eye Allergies, Itchy Eyes
930.00 Something in your eye
372.03 Pink eye
379.93 Red Eye
372.71 Irritated Eye
368.8 Blurred Vision
370.33 Dry Eye
375.21 Tearing, Watering
368.15 Flashes of Light
379.24 Floaters, Seeing Spots
368.2 Double Vision
368.13 Light Sensitivity
V19.1 Family History of Eye Disorders, other than needing glasses or contacts.
373.00 Eyelid Infections
362.5 Macular Degeneration
378.9 Eye Movement Problems, Eye Turn, Lazy Eye
Medical Conditions that have ocular implications are also covered, such as:
I just need a routine check up and I don’t have a vision plan, why are you asking for my medical insurance?
Your medical insurance may often cover routine eyecare. If you are coming in with healthy and normal eyes, you are coming in for routine eyecare. Routine eyecare may be covered by your medical insurance like BCBS, and can also be covered by a standalone vision plan, like VSP. It is all pretty confusing; Kreda Eye Center is dedicated to figuring out the details for you. Let us help save you money by making sure you are utilizing your full benefits.
We also like to know who your medical carrier is because if there is a medical eye condition, they most often will be able to cover your costs. Additionally, if a referral needs to be made, it will help get you to the most appropriate doctor.
To better understand the specifics of what is covered by vision and medical insurance, please call our trained insurance staff: (954) 749-0000.