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Eye Education Corner

Health Insurance Vs. Vision Plans: Which One Should You Use?

If you haven’t read my previous two articles on this series, you can find them on our Facebook page or our website. Those articles address the difference between optometrists and ophthalmology as well as what constitutes a full eye exam. The focus of those articles was to help you understand how to get more appropriate care based on your need (article 1) and how to make sure you are getting the most adequate care for what you pay (article 2). The purpose of this article is to clarify an issue we encounter on a daily basis with our patients, the purpose and function of vision plans. Numerous patients who present with an acute or chronic medical issue affecting their eyes frequently tell us “Doc, I didn’t come in sooner because I don’t have eye insurance.”

Pensive woman with glasses

Let me be very clear on this issue. When we’re dealing with annual visits for glaucoma, diabetes, macular degeneration, or any kind of medical condition that happens to be affecting the eyes, we charge your MEDICAL INSURANCE. A vision plan is simply to help cover the cost of the refraction (“better with one or two”) and the purchase of glasses or contact lenses.

It’s very important to understand that vision plans are NOT insurance. Vision plans work more like a COSTCO membership. You pay for a “membership” and with that membership comes discounts toward refraction fees and the purchase of materials. However, when you take into account the limitations placed on how you spend your money by restricting what or when materials can be purchased, and that on average you only qualify for a complete pair of glasses once every two years the question remains whether you are really saving money? Do these companies have your best interest in mind? The downside of so many vision plans is that they are designed to allow you to use the materials that gives them more profit, regardless of the quality you are getting. Doctors are also being driven to see an average of three times more patients because vision plans continually decrease the amount they compensate doctors toward your refraction and materials. This in turn greatly affects the quality of your visit.

Our goal is to help you truly understand how to best utilize your medical insurance and vision plan policy to your best advantage. It’s quite simple actually, if you have a medical condition that is affecting your eyes, the office will bill your medical insurance for an annual routine visit and any additional visits for further testing of this medical issue. If you carry a vision policy, we will submit the claim for the materials on your behalf and you will receive a refund for what they allow you. This method allows you more savings from the doctor being able to lower their prices on one end and the insurance giving you money back on the other without compromising the quality of your materials or the eye exam. Another option is to simply cancel the vision plan, put the same amount of money into a savings account and ask your doctor for the “prompt payment price” for services and materials. You will save considerably more altogether.

And as you shop around, make sure to compare apples to apples so you don’t compromise the quality of the services and materials you are purchasing. Remember the saying that there’s no such thing as free lunch… well, those amazing online or doc-in-a-box deals for glasses have a catch… you pay less because they sell discontinued frames without any warranty, their lens technology is from 20-30 years ago and you only spend 5-10 minutes with the doctor.

Follow us on social media or our website to follow our promotions. See you on your next eye exam!

The Structure Of A Full Eye Exam & Why You Need One Annually.

Hello, again folks!

In our last article, we discussed what items distinguish optometry from ophthalmology and the fact that the best use of your time and resources is to have an optometrist be responsible for your traditional eye care and then they can guide you to the appropriate ophthalmologist should the need for a specialist arise.

Today we’re going to review each part of a full eye exam, why you should have a full eye exam once a year, and then we’ll talk a bit about the difference between various optometric practices.

A general or primary care eye exam has four basic parts: The interview, the refraction, the anterior segment evaluation, and the posterior segment evaluation. A thorough interview will cover systemic and eye-related history for the patient and family members as well as medication history and lifestyle questions. The purpose is to identify correlations between the history and the findings we note during the exam. This also contributes to visual recommendations based on how the patient utilizes their eyes on a daily basis or for specific tasks.young adult brunette looking at eye test machine in ophtha

The refraction is the visual portion of the exam… you know… “is it better on one or two”? This is what we’re best known for and the main reason people come to see us. We all want to see clearly! It’s more difficult to learn, work, drive, etc if the world looks blurry! The refraction allows us to fit each patient in need with custom eyeglasses or contact lenses and ensure they have the best quality of life their eyes can give them.

This brings us to the most important portion of the eye exam, and the reason why everyone should be seen on an annual basis regardless of their visual acuity, it is the health portion of the exam. This portion of the exam covers both the anterior and posterior segments of the eye. Our visual system processes most of the daily sensory input our bodies receive so it is essential to ensure the overall health of this system. Here we screen for things like glaucoma, macular degeneration, dry eye and keratoconus. Many may not know that in addition to these eye-related problems, during the dialated portion of the exam your eyes become a literal window into diabetes, high cholesterol, high blood pressure, and other systemic problems that we can use to diagnose, monitor, treat and/or refer to other medical professionals to begin life saving treatment. Many of these conditions have the potential to cause blindness and would not otherwise be noticed until it was too late. Understanding these facts helps to educate patients and their friends and family (even those with perfect vision) of the importance of a complete annual eye exam. By now you should texting the people you care about with “perfect” vision so they can read this article and schedule their first eye exam.

As we talked about in the first article, an optometrist should be used as the first line of defense for your vision needs, but how can you find one that best meets your needs since there are so many options out there? There are basically two categories within optometry, those who are focused on speed and sales and those who focus on a medical model. Optometrists working within a corporate or commercial setting are limited by vision plans and corporate regulations as to the amount of time that can be spent on each patient and are focusing on the product being sold whether it is glasses or contact lenses. Their high means a higher chance that a more complex issue may be overlooked. Optometrists who focus on a more medical model are focused on the health of your eyes as well as committed to providing excellence in the best available products for your vision. Finding disease through dilation or other advanced technology is hands down the safest and most accurate option, but this requires sufficient time and equipment which most commercial settings simply don’t invest in.

My primary focus with each patient is YOUR HEALTH! And my commitment to each patient is that along with my staff, I am invested in using the best resources at my disposal to care for your system and eye health. This is because I want you to experience the highest quality of life your eyes are capable of giving you. I use the most advanced technology on the market which allows me in most cases to complete the health portion of the exam without dilating eye drops, and to complete other critically important tests onsite in our clinic. I also have a strong working relationship with every vendor we use to guarantee quality and warranties for each product sold in our office. I am happy when my patients are happy and healthy and receiving the complete care they need and deserve!

Optometrist vs. Ophthalmologist: What’s The Difference?

I would like to introduce all of our patients and friends to a series of articles that will help you, your family and your friends to be better prepared to make the best decisions about how to take care of your health through your eyes, and to understand what your options are while doing so.

Let’s start by discussing different ways in which optometrists and ophthalmologists practice.

Ophthalmologists attend 4 years of medical school before specializing in eyecare. They go through 4 years of general ophthalmology and if they choose so, they can attend another 2 years of fellowship to become more specialized as a cornea, retina, glaucoma, neuro or pediatric specialist. Most ophthalmologists focus their attention on secondary and tertiary care, which include more complicated cases that require more intense or invasive treatments. Their offices tend to be very busy because they receive referrals from an overwhelming number of primary care practitioners.shutterstock 628391861

Optometrists on the other hand attend four years of optometry school after earning an undergraduate degree. During those four years, we focus on the clinical aspects of eye disease management, fitting of simple and medically necessary contact lenses, and we spend a great deal of time studying the neurological relationship to the eyes and are trained to care for pediatric patients and brain injury patients who have delays in vision development or visual issues due to disease or trauma (this may include such treatments as vision therapy). We are mainly responsible for primary care and some also care for patients at the secondary level.

Although both professions have the capability of helping you with basic and simple visual issues, the ideal approach, and best use of your time and resources would be to have an optometrist, such as yours truly, be responsible for your primary eyecare and then be referred to the secondary or tertiary ophthalmologist should the need arise. My staff and I often hear reports from new patients that they were dissatisfied with a primary eye exam at an ophthalmologist’s office because they didn’t feel that the doctor spent enough time with them and that’s because they have to move faster on the simpler cases in order to have time to spend with more complicated cases.


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