The Difference Between Medical Insurance and Vision Insurance

There are multiple differences between medical and vision insurance, and knowing which will cover your eye exam, your glasses or contacts, or other eye care services can be confusing. But, that’s what we’re here for – to help you sort through the confusion and determine the best course of treatment!

First, let’s define how these two types of insurance differ.

There are two parts to an eye health examination: the eye health portion and the vision examination portion. Vision insurance only pays for the vision component of an eye exam. So, if you stop into Clarke EyeCare Center for a standard, routine eye exam, you need vision insurance in order to cover the costs. During the routine vision exam we evaluate how clear you are able to see, whether or not you need glasses, any changes in your prescription, suitability of your eyes for contacts— as well as laser vision or refractive surgery, color vision and more.

During the eye health portion of your exam, we will evaluate, detect and determine treatment for a number of conditions, including, but not limited to, glaucoma, cataract, macular degeneration, diabetes, high blood pressure, allergies, treatment of an eye injury and more. If you have a condition such as glaucoma, for example, your medical insurance will usually cover the exam. The same is true if you’re being diagnosed with a specific condition. If the doctor finds something during your vision exam that needs further testing, the doctor will have you come back for a follow up appointment that will be considered medical, and medical insurance will typically apply.

At Clarke EyeCare Center, we will scan both a patient’s medical and vision insurance cards in case there is a need for medical insurance to pick up the costs of an appointment.

So, what types of things does vision insurance cover that medical doesn’t?

Well, vision insurance plans typically have a savings plan that go toward materials like contacts or glasses. Medical typically doesn’t. Sometimes, your vision insurance will also help cover appointments like fittings for contact lenses.

Curious about the costs?

Vision insurance plans can vary in price and that price is typically relative. The less you pay per month on a plan, the less your insurance will help cover materials like glasses and the more you’ll have to pay out of pocket. Vice versa, the more you pay per month on a plan, the less you’ll pay out of pocket on things like copays, deductibles, etc.

At Clarke EyeCare Center, we accept a variety of insurance plans.

Vision:

  • VSP

  • VCP (Humana)

  • EyeMed (Insight and Access plans)

  • Superior (Select and South West Select plans)

  • Davis (for Howmet employees only, not traditional Davis vision plans)
     

Medical:

  • BCBS

  • Aetna Cigna

  • United Healthcare (and Health Select)

  • UMR

  • TML

  • Tricare (prime and standard)

  • PHCS

  • Medicare

  • Health Smart/Santa Rosa

  • Ameritas
     

We are also listed as providers for several other smaller insurance companies. Please call to ask one of our team members if you don’t see your carrier on this list.

While insurance is a wonderful benefit, it can be quite complicated and we encourage everyone to check with his or her insurance company each year to see if they are covered for an exam.

Back to all blog