We just had an experience in the office today which inspired me to return to the blog. I’d like to begin by apologizing for the extended gap between posts. Sometimes life finds a way…and as the father of a Girl Scout during Cookie Season, well, let’s just say I’m sorry I was away.

Now back to business. There can be much confusion for patients about insurance. It’s bad enough trying to understand the nuances of deductibles and copays when dealing with medical visits, but it gets even more complicated when you go to your eye doctor.
What most people don’t understand is that we almost never work with medical insurance at your optometrist’s office. Unless you are coming in to treat an infection, stye, or other medical issue, we don’t need your medical insurance, and we cannot bill it for your routine eye exam. Your eye exam is billed using a Vision Insurance.

Which Vision Insurance Do I Have?

This dichotomy in insurances can create confusion when you schedule your appointment, or when we request your insurance information. Most optometrist offices will want BOTH your medical and vision insurances. Even though we will only bill the Vision plan for your routine eye exam, we like to have the medical on file in case you need to be seen for an infection or emergency situation.

Figuring out which Vision Plan you have is where things can start to get a little tricky and confusing. Knowing your medical insurance almost never tells us which vision plan you. It can give us an idea where to start, but not always. Each individual Medical Insurance contract can have a “subcontractor” for the Vision plan which can be any number of insurance carriers.

For example, let’s say you have United Health Care (UHC) for your medical insurance. The associated vision plan can be Spectera, VSP, EyeMed, or even something more obscure.

All of this is made even more confusing when your medical insurance insists on naming their Vision Plans with “branded” names which actually aren’t what they are. Blue Shield can have “BlueView Vision” which is actually EyeMed, or United Health can have “United Vision” which is actually Spectera.

Confusion And Anger

Unfortunately all of this can be extremely confusing to patients, and as eye care professionals we have to ask questions you may not even know the answer to. This can sometimes lead to heated conversations at the front desk as we try and sort through which Vision Plan you actually have. Please be patient with the front desk staff. It’s just as frustrating for us. In the end, we just want to make sure you are charged appropriately and we can see you for your visit.