Insurance can be confusing—especially when it comes to eye care. Many patients are unsure whether their visit should be billed to vision insurance or medical insurance. At Eye Trends Summerwood, we understand that clarity is key to a stress-free appointment. Our team is here to guide you every step of the way, from verifying your coverage to helping with out-of-network claims.
In this blog, we break down the difference between vision and medical insurance, which services fall under each, and what you can expect when it’s time to pay.
Vision vs. Medical Insurance: What’s the Difference?
The key distinction between vision and medical insurance lies in the reason for your visit.
- Vision Insurance covers routine eye exams and prescriptions for glasses or contact lenses. Essentially, if your visit addresses vision that can be corrected with lenses, it’s billed to your vision plan.
- Medical Insurance covers eye health issues and diseases—anything that cannot be fixed with glasses or contacts.
“Vision only includes anything that can be fixed through glasses or contacts,” our doctor explains. “Medical insurance covers conditions like dry eye, cataracts, diabetic eye exams, or red eye.”
Common Services Billed to Medical Insurance
If you’re coming in for one of these concerns, your exam will likely be billed to your medical insurance:
- Diabetic eye exams
- Dry eye evaluations
- Cataract evaluations
- Red eye or pink eye
- Foreign body removal
- Any eye health issue not related to vision correction
Patients often assume that diabetes or pink eye visits are “routine exams,” but these fall under medical coverage, not vision insurance.
How to Verify Your Coverage
Our website lists many of the insurance plans we accept. If you don’t see your plan listed, call our office, and our friendly staff will:
- Take down your insurance details
- Verify whether we’re an in-network provider
- Help you understand your benefits before your appointment
If we’re out of network, we’ll assist you with self-submission so you can seek reimbursement directly from your provider.
What to Bring to Your Appointment
To make your visit as smooth as possible, please bring:
- Your driver’s license
- Your medical insurance card
- Your vision insurance card, if applicable
Our front desk team will confirm your details and help determine the correct coverage based on your primary reason for the visit.
Understanding Payment Options
Transparency matters to us. If a service or product isn’t fully covered, we’ll let you know before proceeding.
For glasses, a 50% deposit is required to start your order, with the balance due upon pickup.
We accept:
- Cash
- Credit/debit cards
- CareCredit – a convenient financing option offering 6 months interest-free if paid in full within the promotional period
“CareCredit is a great option for patients who need a little extra time to pay,” says our team. “It helps make quality eye care accessible.”
The Truth About Vision Insurance: It’s Often a Discount Plan
Many patients think vision insurance functions like health insurance—with copays and full coverage. Unfortunately, that’s not the case. Most vision plans are discount-based, providing:
- Partial coverage or stipends for frames
- Discounts on lenses
- Limited coverage for contact lens evaluations
In some cases, paying out-of-pocket may be more cost-effective than paying monthly premiums for vision plans that offer minimal benefits.
“A patient once told us they paid $20/month for a plan that only gave 15% off exams and 30% off glasses. Over a year, they spent more than their actual savings!” the doctor shared. “It’s always best to check your plan details before committing.”
Plan Ahead with Our Team
Before your next appointment, talk to our staff about your insurance benefits. We’ll help you:
- Understand what’s covered
- Budget for any out-of-pocket costs
- Choose the best options for your needs
Our goal is to ensure you feel informed and confident about your care—no surprises, no confusion.
Final Thoughts
At Eye Trends Summerwood, we believe in patient education. Understanding the difference between vision and medical coverage helps you make smart decisions about your eye health and budget. Whether you’re scheduling a routine exam or managing a medical eye condition, our team is here to help you every step of the way.
Schedule Your Next Eye Exam
Ready to book your appointment or verify your insurance coverage?
Call us today or visit our website to learn more.