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Understanding Vision and Health Insurance Benefits At Your Visit 


Dr. Valella is a participating provider with Blue Cross/Blue Shield, United Healthcare, Medicare, Medicare Advantage, Aetna, Priority Health, Co-finity, MEBS, Humana Gold Choice, Humana Gold Choice PPO, Superior Vision Services, VSP-Messa, and Delta Vision. Other insurances are handled on an individual basis.



Most patients do not understand the difference between using VISION PLAN BENEFITS vs HEALTH CARE PLAN BENEFITS in our practice. 


VISION PLAN BENEFITS apply to exams that have no medical conditions being examined or if you do not have any medical complaints.  Essentially "vision" exams are wellness exams for the eye and typically include testing for glasses and contact lenses and screenings for disease. 

HEALTH CARE PLAN BENEFITS apply if you have any medical eye or systemic conditions, or medical complaints the doctor is evaluating for you.  This would include things such as a past history of medical eye conditions that need to be checked at regular intervals such as: cataracts or cataract surgery, high eye pressure or glaucoma, macular degeneration, dry eyes, allergies, cornea disease, flashes and floaters, eye infections and injury, diabetes, high blood pressure, high cholesterol, autoimmune disease, systemic medications or conditions that can effect the eyes. Often patients are surprised to learn their visit with us is a Health Care Plan Benefit and not a Vision Plan Benefit. 

Please remember, we are not able to guarantee
insurance coverage for our services.

-see "Patient Forms" Tab - Check In Forms. 

 

 ****EXAMPLES****


VISION PLAN BENEFITS:


1. You want new glasses or contact lenses and you feel your vision isn't as clear as it used to be and it is because your prescription has changed.
2. You have headaches and it is because you need reading glasses.
3. You have no complaints but just want your eyes checked.
The above 3 are billed under VISION PLAN BENEFITS.


 HEALTH CARE PLAN BENEFITS:


1. You've noticed your vision is blurry and the doctor determines you have cataracts.
2. You have headaches and it is because your optic nerve is swollen.
3. Your last eye doctor was watching you for glaucoma.  
4. Your eyes feel dry, gritty, itchy and they water occasionally.
The above 4 are billed under HEALTH CARE PLAN BENEFITS.


If you are wondering how your particular conditions or symptoms would be submitted to your vision or health care plans, you may email us with your questions at:

office@CanYouSeeClearly.com 

Subject: Insurance Questions