By Zack Steele
I hear from people all the time that say they can’t afford to go to the eye doctor because they do not have ‘vision’ insurance. I also hear just as often that a patient can’t see the doctor he or she wants to see because that doctor does not take a specific vision plan. These are misconceptions that I would like to try and clear up.
Just because you might not have vision insurance doesn’t mean you have to pay out of pocket for a comprehensive eye exam. In most cases, patients have medical problems that will allow for their health insurance to cover their eye exam. For example, if you have high blood pressure, diabetes or allergies that affect your eyes, your medical insurance will likely cover the exam. Several eye care professionals refuse to accept certain insurance plans because they pay doctors so poorly while at the same time charging high premiums to the patient.
Most if not all of these plans will allow you to file “out of network” so they will reimburse you for your visit to an out of network eye doctor.
One plan in particular is very strategic about this, in that its goal is to drive patients into commercial eye centers like a Lenscrafters, or Sears, which they also own. The low reimbursement means few private practices will accept these plans, therefore driving patients to these “big box” eye centers.
Keep in mind that there are plenty of capable eye care professionals who work for these commercial places. Most of the doctors I know provide adequate care, though they are often limited in what medical eye testing they can do.
My advice to people that have these types of plans is to not sign up for them. By the time you have paid the premiums for these vision plans, you could have saved that money and paid for a really nice pair of glasses or supply of contact lenses out of pocket. And remember what I said initially, medical insurance will cover most people for an eye exam if they have something medically wrong with them that necessitate an eye exam.
There is a debate right now in eye care about if vision plans are actually needed. As optometry has shifted over the last 50 years into a major contributor to mainstream health care, many wonder what the point is of having a vision plan at all.
I think from reading this you can probably tell how I feel about this debate over vision plans.
The take-home message here is that you should be able to see the doctor you want when you want. Vision plans make it seem like you can’t. I am here to tell you that you can.
Dr. Zack Steele is a 2003 graduate of the UAB School of Optometry. His practice, Trussville Vision Care, is located on Chalkville Mountain Road in downtown Trussville. He currently serves as the president of the Alabama Optometric Association.