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Vision Vs. Medical Insurance

Many of the questions we receive at Everett And Hurite have to do with insurance. One particularly common question is whether or not visiting patients can use general medical insurance, rather than vision insurance, to cover their visit.

For most patients at Everett And Hurite, the type of insurance that they can use to cover their visit will primarily depend on the purpose of their appointment. Our staff members are qualified to deliver two key types of examinations: wellness vision exams and medical eye exams. While these exams often contain similar testing and procedures, insurance companies classify them as two different types of exams. The companies make this distinction based on the purpose of the exam and your appointment overall:

  •  Wellness vision exams are the standard eye exam that patients undergo annually. These basic vision exams include screenings for eye disease and eye refraction tests (which determine the prescription you’ll need for 20/20 vision if you wear glasses or contacts). Wellness vision exams are often only covered by vision insurance.
  • Medical eye exams are visits scheduled specifically to diagnose and/or treat a medical condition within the eye. These exams are often scheduled as a follow-up to a routine exam, as abnormalities and health issues typically appear in tests during a standard wellness vision exam. Medical eye exams are often covered by medical insurance.

While these are the standard rules for vision and medical insurance use at a vision center, some specific health plans may cover additional items than what is listed here. This means that depending on your insurance plan, your medical insurance may actually cover some aspects of your eye care.

Given the complexities of different health insurance policies, we always recommend that you call your insurance company or speak with your HR department to verify your specific plan’s benefits and coverage before you visit Everett And Hurite. Your insurance company is the best source to answer questions about your coverage.

You should also clarify which company or companies cover your vision and medical insurance, as two different companies often cover these insurance policies. Confirming this information before an appointment will avoid any confusion or problems when you come to our offices for your exam.