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Home » Insurance » Undestanding Your Medical or Vision Plan

Undestanding Your Medical or Vision Plan

At Derby City Eye Care, we accept a wide variety of medical and vision insurance plans in an effort to keep healthcare costs as reasonable as possible for our patients. Vision insurance typically provides coverage for routine eye examinations and prescription eyewear or contact lenses, and medical insurance is used for eye emergencies, injuries, and diseases. The following is an overview of the most popular insurance plans accepted at our office – please check your individual plan documents or contact your insurer for specifics:

VISION

  • EYEMED (Blue View Vision) – this insurance is offered as a low-cost individual or family plan, as well as through a wide variety of employers in our area including some local health care facilities and the Oldham County Schools. It is typically offered in conjunction with Anthem or Humana Medical Insurance. EyeMed eye exam copays at our office are usually $10 or less, though each plan is different. EyeMed gives each of its members an allowance (usually $100-$300) to use toward the purchase of either glasses or contact lenses once a year. Though the Walmart Vision Center does not contract with EyeMed directly, it can provide paperwork to submit for reimbursement of glasses and contact lens expenses incurred at their location.
  • VSP (Vision Service Plan) – similar to EyeMed, this insurance is offered as an individual or family plan, and is also popular with many small businesses in Oldham County. It is a stand-alone vision insurance plan, which means it is offered without any medical benefits. As out-of-network providers for VSP, eye exam copays at our office are typically $20-$35. Like EyeMed, each of VSP’s members also get an allowance (usually $150-$350) to use toward the purchase of either glasses or contact lenses once a year. However, unlike EyeMed, the Walmart Vision Center does have a contract with VSP, so you can apply your allowance directly toward your purchase.
  • DAVIS – this insurance is offered in some parts of our area, and is the official vision insurance of the University of Louisville. Like VSP, it is a stand-alone vision insurance plan without medical benefits. Davis eye exam copays at our office are typically $0, and some Davis plans even pay for a contact lens fitting and evaluation (which is not covered by EyeMed or VSP). Davis gives its members a variable allowance to use toward the purchase of either glasses or contact lenses every one to two years, depending on the plan. Like VSP, it also contracts directly with the Walmart Vision Center.
  • SPECTERA – this insurance is also offered by businesses in our area, typically in conjunction with United Health Care Insurance. Spectera eye exam copays at our office are typically $10, and like the other plans, its members get an allowance toward the purchase of either glasses or contact lenses every one to two years. Spectera also contracts directly with the Walmart Vision Center.

MEDICAL

 

  • MEDICARE – this insurance is offered by the federal government to those who are 65 and over. It is the most common medical insurance across the country, and in our area as well. As a medical-only plan, Medicare does not provide any coverage for a routine eye exam for glasses or contact lenses, nor does it provide an allowance for the purchase of glasses or contacts (except after cataract surgery). However, it does cover eye exam costs associated with diabetes, cataracts, glaucoma, macular degeneration, and other medical eye conditions. Medicare copays at our office are $0, though Medicare may not cover the total cost of the exam depending on the deductible and type of services rendered.
  • MEDICAID – this insurance is offered by the state government to assist individuals and families. Some Medicaid plans may also have vision benefits, but they cannot be used on the same date as a medical visit. Medicaid copays at our office are $0-$3, depending on the plan, and cover the entire cost of the services rendered for the medical visit.
  • ANTHEM – this is the most common, non-government medical insurance offered in our area. Anthem medical insurance covers eye exam costs associated with eye infections and injuries, as well as medical eye disease like cataracts, glaucoma, and diabetic retinopathy. Copays typically run from $0-$25, though exam services may not be fully covered and are subject to the deductible.
  • HUMANA – this insurance, headquartered in Louisville, is another very popular medical insurance in our area. Like Anthem, it covers eye exam costs associated with medical eye disease, infection, and injury. Copays are usually in the range of $0-$40, and services may not be fully covered if subject to a deductible.