Vision Insurance
Vision insurance is usually optional coveraged added to your insurance package that covers 'routine' eye wellness exams. This insurance may or may not include allowances or coverage for spectacles, lenses, or contact lens related fees. The plans normally allow for an 'eye exam' once per calendar year, although plans vary. Examples are Spectera, Davis Vision, and Eye Med.
Medical Insurance
An optometrist is a medical specialist (optometric physician) and most optometrists participate as providers for care which is covered by your medical insurance.
This care would be covered as a specialist, much like a visit to a cardiologist, allergist, chiropractor, or ENT. Depending on your insurance policy, you may require a referral from your PCP to see a specialist. If there is a medical necessity for the exam, then usually most of the exam fees will be covered by your medical insurance--regardless of whether or not you have a vision plan or "vision insurance." Some common medical problems which would warrant an eye exam would be dry eye, blurred vision, pink eye, diabetes, head aches or eye strain. Examples are Medicare, Medicaid, Anthem, Blue Cross/Blue Shield, and Aetna.
"But my insurance only covers an eye exam once a year." This statement is referring to the vision care policy, and your 'vision' wellness exam (as described above). Medical eye care, like any other 'specialty,' is covered as often as is seen fit by the physician (or PCP if a referral is needed). Contact us with any questions regarding your 'vision' versus 'health' insurance.