I came in for my yearly eye exam – shouldn’t it be billed to my "vision insurance"?
If you have any medical concerns such as cataracts, intraocular pressure, or dry eyes, symptoms describing a possible medical problem or any similar medical diagnosis, then medical insurance must be billed.
What is the difference between Vision Insurance and Medical Insurance for an eye care visit?
Vision Insurance (VSP, Eyemed) covers routine vision care (i.e. regular eye exams for glasses and contacts) when no medical eye problem or related complaint specifically exists.
Medical Insurance (Aetna, Blue Cross Blue Shield, Medicare, etc.) provides benefits for the treatment of medical problems including medical eye problems. To obtain coverage under medical insurance, a symptom or complaint indicative of eye disease, eye injury, or a chronic medical condition is one of the reasons for your visit or the doctor.
Although the examination that you receive may seem to be the same or similar to previous visits, the reason for the exam and the doctor’s diagnosis dictate how we must bill our patients.
