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Vision Plans Coverage

Most of us have vision plans, and it's tough knowing what the coverage is and where we should go, so here are a couple of pieces of advice. Read below for a better understanding of how vision plans work.

What do they cover...

Most vision plans cover an eye exam. This exam is routine. Routine means it is not an exam for treating a disease like pink eye. If you have an aging condition such as Cataracts and do not intend to have surgery is okay to use your vision plan. Also, if you have Diabetes, many plans have special provisions for Diabetic patients who may require constant screenings; again, like Cataracts, it is ok to use your vision plan. The Vision Plan should cover routine exams if you intend to get new glasses or contact lenses.

 

Before scheduling your exam, consider whether you need new glasses or contact lenses. This is very important as some plans may require authorizations. Also, the clinic has to schedule in addition to your eye doctor, a licensed optician, or a contact lens specialist to perform that part of your visit so appropriate personnel is scheduled. The ancillary staff is an important part of the eye care team. If you intend to have the eye exam alone, tell the provider when you make the appointment so resources aren't wasted.

Ideally, you should purchase your eyeglasses and/or contact lenses from the same facility where you get the eye exam. Here are a few reasons why:

  1. Prescription lenses are based on the physician's prescription, based on the answer you provide in the exam; if your prescription changes, a period of adaptation may be needed. If you do not get used to this change, the physician may tweak the script to make it more comfortable.  This requires a remake of the lenses. It is easier to remake lenses if you did the exam at the same facility, as the ultimate goal is satisfaction. Better communication.

  2. Your eye doctor has agreed to receive a discount reimbursement to service you, saving you money on prescription glasses and/ or contact lenses.

  3. Many vision plans use their labs, and the lab provides a warranty. Only labs approved by the vision plan are to be used. Quality. If you go to a location that is not approved, it will cost you more and you may not have the warranties.

  4. Many "super-opticals" display frames showcasing identical frames in different colors giving the impression of a larger selection. Private Opticals probably displays a larger selection of styles of different brands and designers. Most of our frames come in 10 colors and 3 sizes, allowing your licensed optician to fit you in the right size.

Glasses or Contact Lenses, but not both!

Almost all plans cover glasses (Frame and lens) or Contact Lenses. but not both. So you have to decide which is a better deal with your plan.  Your plan has arranged for you to get the best options at a reduced cost so that you can get a loaded pair of eyeglasses with all the latest coatings and designs.

 

Contact lenses are the other option. They come in premade or custom-made. Contacts correct almost all refractive errors. Most vision plans pay for a portion of your contact lens fit evaluation and give an amount for the lenses. Be aware that most contact lens manufacturers provide "Free Samples" but charge the practitioner shipping and handling fees. You are responsible for these fees if your plan does not have material benefits. 

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