What Is the Difference Between Vision Insurance and Health Insurance?

Submitted by Atlanta Vision Cataract and Laser Center on October 26, 2022
Difference between vision and health insurance

Insurance policies are notoriously complicated. Every day, the team at Atlanta Vision Laser and Cataract Center helps our patients to navigate their policies to determine which benefits they are entitled to. One of the most common questions our staff hears is: What is the difference between vision insurance and medical insurance? In this blog, we describe the types of situations where a patient should use one form of insurance instead of the other.

Vision Insurance

Most health insurance plans do not pay for standard eye care services. Vision insurance is a separate plan that provides full or partial coverage on things like annual eye examinations, contact lenses and eyeglass frames. It is a good idea for any patient who wears prescription lenses to maintain vision insurance to help defer costs on the lenses that correct their nearsightedness, farsightedness and astigmatism.

Vision insurance rarely covers vision expenses in full. Co-pays and out-of-pocket costs are common. The plan should outline the benefits available to the patient. Some of the more expensive plans may include extra perks like transition lenses. Almost no vision plans cover LASIK since it is an elective surgery, but patients with insurance do often qualify for a discount.

Health Insurance

What makes insurance particularly confusing for eye care patients is that a lot of eye conditions are covered under general medical insurance. Generally, non-refractive issues that pose a threat to ocular health or rise to the level of a medical emergency fall under the umbrella of health insurance. This applies to serious conditions like cataracts, glaucoma, age-related macular degeneration, dry eye, conjunctivitis or a traumatic injury to the eye. If vision impairment is caused by another health ailment such as diabetes or heart disease, health insurance probably also covers that treatment.

Combining Plans Is Not Option

With certain eye ailments, it can sometimes appear as though both vision and health insurance should cover the treatment. However, using both forms of insurance is not a possibility even if it seems cost efficient. By law, eye care centers are forbidden from billing more than one insurance company for a single appointment. Nevertheless, our practice encourages patients to bring both vision and health insurance cards to any appointments so that we can utilize the one that offers the best benefits for that appointment.

Our Friendly Staff Is Here to Answer Your Questions

As patients throughout the Atlanta region attest, we take the time with our patients to help them get the most savings from their insurance plans. We are accustomed to answering a variety of questions pertaining to insurance. At Atlanta Vision Laser & Cataract Center, we accept most major insurance,  including Anthem, Aetna, Cigna, United Healthcare, Humana, Eye Med, Superior Vision, Guardian, Medicaid and Medicare.

If you are overdue on a comprehensive eye exam, please schedule an appointment at our office by calling (404) 765-2020.