Know Your Eyecare Benefits?

Not infrequently members with visual symptoms or eye discomfort who visit our WebMD Vision & Eye Disorder Message Board express reluctance about visiting the doctor.
There folks aren't necessarily afraid of the doctor or apprehensive about a worrisome diagnosis. Many folks insured by their employer think they do not have adequate coverage. Specifically, they are confused about the difference between the employer's Vision Plan and their regular health insurance.
Most Vision Plans offer routine healthy eye checkups, a refraction, and prescription eyewear. There may or may not be a co-payment. In many workplaces a Vision Plan is not offered or optional (read: you pay!).
Vision Plan participation offers limited benefits. For example, your Vision Plan may entitle you to one exam and one pair of new glasses per year. Given the cost of prescription spectacles a Vision Plan is a solid benefit that should not be overlooked. Some people mistakenly believe, however, that receiving that one Vision Plan visit makes them ineligible for eye care for the remainder of the year.
Does that leave you uncovered if you think you have an eye problem? Not at all!
Your regular health insurance will cover the costs for treating medical and surgical diagnoses involving the eye, orbit and surrounding structures. If you experience difficulty seeing or other problems involving your eyes contact your insurer or primary care provider for a referral to an eye doctor in your network.
Depending on the terms of your policy you may be immediately referred to an optometrist or to an ophthalmologist. Interestingly, in most areas, the charges for the initial visit are the same whether you see an optometrist or ophthalmologist. Either doctor can refract you for new glasses, but without a Vision Plan you will need to pay out of your own pocket when you visit the optical shop.
Assumptions often lead to uninformed decisions. It's important to familiarize yourself with all of the different medical and dental benefits that are available to you and your family. Your company Human Resources team can quickly clarify any misunderstandings now before the need for care arises.
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