Vision Insurance vs. Medical Insurance – An explanation

A vision insurance policy is not the same as health insurance. Who knew? Well, we did. And, we want you to know, too. Regular health insurance plans protect you against financial losses due to unexpected eye injuries or disease. Vision insurance, on the other hand, is a wellness benefit designed to provide routine eye care, prescription eyewear and other vision-related services at a reduced cost.

Vision insurance usually involves a fixed benefit or set of benefits, which can be utilized to receive annual wellness eye examinations and materials such as eyeglasses and contact lenses. The plan predetermines the benefits, as well as how often the benefits can be utilized, so you’ll want to check that out. Vision insurance does not cover medical eye care. If a medical symptom or diagnosis exists, vision insurance will generally not cover the visit. Conditions that are covered on vision insurance include nearsightedness (myopia), farsightedness, (hyperopia), astigmatism, and presbyopia.

Medical insurance involves the diagnosis and treatment of medical conditions related to the eyes and visual system. Medical insurance generally covers enough visits to completely diagnose and treat medical conditions. Materials such as eyeglasses and contact lenses are not covered by medical insurance, so you’ll want to look into the coverage you have. Some common medical conditions of the eye include cataracts, glaucoma, and age-related macular degeneration.   Some medical insurance plans do cover an annual eye wellness exam, though some may not.

Vision and Eye Insurance Information

We are happy to report that Maple Grove Eye Doctors offers Eyemed Vision Care® vision wellness plans, Preferred One, Hennepin Health, and most major vision plans, including:

  • Eyemed Vision Care®
  • VSP:  Our office is an Open Access Provider; the benefit for an eye exam will be the same anywhere you go.
    The materials benefit (glasses, sunglasses, contact lenses) will differ from office to office.

    What our office does is deduct your open access benefit, and  offer an additional 30% off that balance for the purchase of a complete pair of glasses.     

    For contact lenses we offer 10% off the cost in addition to your open access benefit.

  • MNCare
  • Hennepin Health
  • Cigna
  • Avesis
  • Most Davis Vision
  • Aetna
  • UCare
  • Blue Cross Blue Shield (BCBS)
  • Health Partners
  • Most Avesis
  • Humana
  • Select Care (Labor Care)
  • Medica
  • Preferred One
  • Superior Vision / BCBS / Medicare (exams and office visits only)
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Insurance Maple Grove
Insurance Maple Grove

Whew! We also accept out of network benefits from many of the leading insurance companies.

To learn more about your vision benefits program:

  • Review your benefits package and/or contact your employer’s human resources department. We find that your companies HR folks are very helpful.
  • Call your vision plan’s customer service department. Some plans such as Eyemed have mobile apps that enable their insured to see their benefits at a glance on their smartphone. We love that.
  • Contact your association’s membership services department. They generally have lots of answers.

If your insurance company isn’t listed, you may still be eligible for out-of-network benefits at Maple Grove Eye Doctors. Since we speak fluent ‘insurance’, we encourage you to contact us to assist you. One call. Done.

Don’t forget! When you visit an optometrist on our team of Maple Grove Eye Doctors, please present your ID card. It’s really important.

Our doctors recommend that everyone experience our advanced technology by having a digital image taken of the back of the eye with our unique and innovative, Optomap. Why, you ask?  Because it allows your doctor to see far more of your retina than is possible using standard technology.  It also allows you to see what they can see.  How awesome is that?  Sure, there is a small additional fee ($39).  One pair – that’s all you have, so choosing this option is a no-brainer.

Another thing that might be good for you to know is that we offer walk-in emergency appointments and 24-hour emergency care for sudden loss of vision, flashes or floaters, pink eye treatment and trauma. If it is important enough for you to call us, then it is important for us to see you.

For after hours, please call / text Jim at 612-599-0153… don’t you see a refrigerator magnet in your future with this information on it?

We will bill your medical insurance for these types of conditions and for routine eye exams, so don’t worry about that. We want you focused on healthy eyes that look GOOD in your new eyewear.