Issue 37.17
Medical insurance is a funny and confusing thing. It can be difficult to know what benefits you have with your plan. We get questions all the time about this and we hear some incorrect assumptions, as well. So, I want to share some things about your eyes and your health insurance coverage.
Medicare and all of the Medicare Advantage plans provide coverage for an eye exam and testing, much like they do for any other doctor. If you feel like you are having any problems with your eyes, then don’t hesitate to schedule an appointment because your insurance will cover these exams. If your doctor is recommending follow-ups or additional testing, then your medical insurance will cover these exams, as well. You are not restricted to one eye exam per year or any other restrictions for visits or recommended testing. There are a variety of reasons that your insurance will cover all of these visits, dry eye, cataracts, glaucoma, high eye pressure, floaters, vision changes, red eyes, infections, allergies, etc.
What you can expect your insurance to cover depends on your specific plan. Do you have a deductible to reach? Are you responsible for 20% of the cost? Do you have secondary insurance?
Here are some basics answers. Medicare has a $183 deductible, then they will cover 80% of the cost, leaving you responsible for remaining 20%. The deductible resets on January 1st each year. If you have a secondary insurance then your out of pocket cost will depend on what plan you have. It could pick up the deductible and the 20% for you, or it may have its own deductible for you to meet first. There are a number of different scenarios that can happen and it all depends on what your primary and secondary insurance plans are. We have 2 full time billers who make it part of their job to find answers to these questions. If you are unsure, call our office and talk to Susan or Barri and they will be happy to get answers for you.
SouthWest Vision is located at 965 E 700 S, St George Utah. Call us at 435-673-5577 or visit our website at www.SouthWestVision.com