Insurance Primer: Some differences between vision and medical plans

McMillin eyecare accepts a variety of vision and medical insurance providers and is glad to file claims on behalf of our patients. While the terms of service vary from plan to plan, the following is meant to highlight the basic differences between vision and medical insurance and to educate you as to when we are obligated to file your claims with your vision providers and when it is necessary to file with your medical insurance.

Vision coverage is designed to determine a prescription for glasses or contacts and to screen for a variety of medical conditions. If the screening does not result in a diagnosable medical condition it is filed with your vision insurance. However, if a medical condition is diagnosed it is necessary to file the visit with medical insurance.

McMillin eyecare will also file claims with medical insurance in the following circumstances:

1. If you have any problems that may be attributable to a medical condition which requires further testing to rule out eye disease. These include but are not limited to:

a) New or sudden blurry vision b) Flashes or floaters c) Dry and/or itchy eyes d) Eyestrain and/or double vision e) Headaches f) Eye pain and/or redness g) Loss of vision

2. If you have been previously diagnosed with an eye issue that requires medical decision making, treatment or management. These include but are not limited to:

a) Cataracts b) Amblyopic/lazy eye c) Glaucoma/high eye pressure d) Macular or retinal disease e) History of eye surgery

3. If you have been diagnosed with a systemic condition that can affect your vision and requires testing, follow-up visits, and reports to primary care physicians. These include but are not limited to: a) Diabetes b) Hypertension c) Thyroid disease d) Lupus or autoimmune disease e) Diseases resulting in the use of high risk medication (ie: Plaquenil) We hope this information has been helpful. If you have further questions please let us know!