When is an Eye Exam a Medical Exam? By Dr. Mark German, Optometrist at Lakeshore Eye Care Professionals in Mequon and Saukville, Wisconsin
We like to use this column to tackle common misunderstandings patients have about their eyes and eye care. So here is a big one: When is an eye exam billed to your medical insurance and when is it part of a separate vision plan? Some patients have both medical insurance and vision plans. The latter is intended for routine eye care and sometimes covers glasses or contact lenses every one to two years.
The difference has to do with why you are having your eyes examined. If you have a medical problem such as diabetes or take medications such as hydroxychloroquine that can affect your eyes, then the examination is billed to your medical insurance. It also has to do what type of eye problems you have. If you have glaucoma or cataracts, those are medical problems so the exam is billed to your medical insurance.
The separate vision plan is for those patients who have nothing wrong with their eyes except for the fact that they wear glasses or contact lenses. It is not intended for those with medical eye problems. Sometimes it doesn’t pay to have a separate vision plan if you have a medical eye problem unless your premium is less than the anticipated discount on glasses or contact lenses. Another difference is which doctor you see. Our ophthalmologists, Drs. Jay and Cueto, generally do not accept the vision plans as 99% of their patients have medical eye problems.
Still confused? You are not alone. Call our office at 262-241-1919 and we can help you sort it out.
Dr. Mark German is an Optometrist with Lakeshore Eye Care Professionals. He practices comprehensive optometry and accepts patients of all ages into his practice. Most insurance plans accepted including Medicare Assignment. His ophthalmology colleagues are Dr. Martha Jay and Dr. Josephine-Liezl Cueto.
For more information, visit our web site at www.LakeShoreVision.com or call 262-241-1919.