While vision insurance covers your optical needs, such as annual vision testing, eyeglasses, and contact lenses, it does not cover any part of your eye care that is considered “medical.”
Many vision insurance plans also do not cover contact lens fittings and yearly evaluations
.
Are contacts free with medical?
Benefits of Medi-Cal vision care
Note that
the state of California may provide free contact lens if the person can’t wear prescription glasses due to some other condition, such as an eye disease
. Free eyeglasses may be given as well. California will only offer this government benefit to individuals under the age of 21.
How do I qualify for medically necessary contacts?
Some of the most common eye conditions that make a patient eligible for this service include Keratoconus (an eye disease that causes bulging of the cornea), Aphakia (absence of the lens), significant Ammetropia (having a prescription greater than +/- 10.00D), and high Anisometropia (when your eyes differ in …
How much does a year of contacts cost?
Contact lenses can cost anywhere from
$150 to $1,500
a year, depending on the brand, type, and your insurance coverage. Generally, they cost between $20 and $30 a box. Most people with average prescriptions should be able to get a year’s worth of contact lenses for $200 to $500.
What is medically necessary contact lens?
Medically necessary contact lenses are
non-elective contact lenses prescribed when certain medical conditions hinder vision correction through regular eyeglasses and contact lenses are the accepted standard of treatment
.
What is Anisometropia?
Anisometropia is
a condition where the refractive error differs between the two eyes
. A difference in spherical equivalent refraction (SER) of 1 diopter or more (SER difference ≥ 1.00 D) is usually used as the definition for anisometropia.
What are considered elective contact lenses?
Contact lenses are considered elective
when the user’s vision correction could be treated with eyeglasses, but instead they select the convenience of contact lenses
. In most cases, vision insurance will only cover one or the other (eyeglasses OR contact lenses) during a benefit period.
What are non-elective contact lenses?
Non-elective contact lenses, also called
medically necessary contact lenses
, are prescribed by your optometrist. Your eye doctor will let you know if you need medically necessary contact lenses. These types of contacts are not covered by a VSP Individual Vision Plan.
What is high astigmatism?
What is considered high astigmatism? A high astigmatism
refers to the numbers on your contact lenses or glasses prescription
. Generally, the higher the number for the axis and cylinder on your prescription, the stronger your astigmatism is. The picture below depicts how viewers with severe astigmatism would see.
Does Medicare pay for contacts?
Original Medicare doesn’t pay for contact lenses under most circumstances
. Some Medicare Advantage plans may offer vision services. In some cases (such as after cataract surgery), Medicare may cover contact lens costs.
Are contacts worth it?
Hard contacts are more durable than soft ones
. They’re easier to take care of but can be less comfortable. They often give better vision for conditions like astigmatism (when your eye is more oval than round) and can be a good choice if you have allergies.
Are contact lenses cheaper than glasses?
Contacts can cost more than prescription glasses
The price depends on a lot of factors, but because of how often lenses need to be replaced (every two weeks or so for disposable contacts) the annual and long-term costs can exceed glasses.
How many boxes of daily contacts is a year supply?
One box
is a year’s supply of contacts. Each box contains 12 pairs of lenses.
Are contacts for astigmatism medically necessary?
If contact lenses are the only method that can improve your vision then contact lenses are usually considered as medically necessary
. Conditions such as keratoconus, dry eye syndrome, corneal scarring, and irregular astigmatism will qualify for medically necessary contact lens benefits.
What is considered irregular astigmatism?
What is irregular astigmatism? Irregular astigmatism is similar to regular astigmatism in that the curvature of the eye’s surface is not perfectly round, but where it differs is that instead of the curvature being evenly shaped (mostly in one direction), it is uneven, or curved in multiple directions.
Are toric contact lenses covered by insurance?
The Toric IOL is Medicare approved.
Medicare and most insurance companies will cover a portion of the cost of this procedure
. New insurance guidelines allow the patient to pay the additional costs associated with the Premium Toric IOL because of its astigmatism correction properties.
What does Exophoria mean?
Exophoria is
a condition in which your eyes drift outward out of your control
. It usually appears for a short time while you’re doing certain types of tasks. It’s not a serious condition and can be corrected with the right treatment.
What is the strabismus?
Strabismus (crossed eyes) is
a condition in which one eye is turned in a direction that is different from the other eye
. Treatment may include glasses, patching, eye exercises, medication or surgery.
Can Lasik fix anisometropia?
Lasik is a common surgery for treating anisometropia
.
What is the difference between elective and necessary contacts?
Non-elective contact lenses, also called medically necessary contact lenses, are prescribed by your optometrist to correct these types of eye problems, whereas
elective contacts are chosen by the patient to correct an eye issue that eyeglasses or sometimes laser surgery can also correct
.
What is the difference between disposable and conventional contacts?
Conventional contacts are generally worn from six months to a year, and are not frequently prescribed due to the improvements in disposable lenses
. They are produced in daily wear and extended wear models and can be soft lenses, hard lenses or rigid gas permeable lenses.
What are polycarbonate lenses?
Impact-resistant Lenses
Thinner and lighter than plastic, polycarbonate (impact-resistant) lenses are
shatter-proof and provide 100% UV protection
, making them the optimal choice for kids and active adults.
Does EyeMed cover scleral lenses?
Contrary to medical insurance, vision insurance plans are meant to reduce the costs for eyewear purchases. For some of our patients who have vision insurance with a contact lens plan, such as through EyeMed or VSP,
a large portion of their scleral lenses will be covered
.
Can I get both contacts and glasses with VSP?
If you exceed your plan allowance, you’ll be responsible for paying the coverage in addition to any applicable copays at the time of your visit. If you choose contacts,
you may not be eligible to receive any frame and lenses during the same service period
.
What is conventional contact lenses?
Conventional contacts are
a type of soft lens, usable for a long term, which is recognized by the typical vials they are packaged in
. Proper care, cleaning and disinfection with correct lens care products on a regular basis can make these lenses last from several months up to a year.
