Vision Vs. Medical Insurance at ReFocus Eye Health Bloomfield

What EyeMed Covers

• Annual Eye Exams: Includes refraction testing to update your prescription.
• Eyeglasses and Lenses: Enjoy frame allowances and discounts on lens options such as anti-glare and progressive lenses.
• Contact Lenses: Coverage includes fittings and allowances for lenses.
• Lens Enhancements: Options like UV protection, scratch resistance, and blue-light blocking are often discounted.
• Special Discounts: Savings on additional pairs of glasses or premium frames.

What VSP Covers

• Comprehensive Eye Exams: Coverage with minimal copays to keep your vision in check.
• Frame Allowances: VSP plans often include allowances for glasses, including featured designer frames.
• Lenses and Lens Treatments: Single vision, bifocal, or progressive lenses with options for premium coatings.
• Contact Lens Benefits: Options to use your allowance for contact lenses instead of glasses.
• Exclusive Savings: Extra benefits for certain brands or optical purchases.

Vision plans are there for your routine eye care, whether it’s for your annual eye exam or contact lens fitting or if you are upgrading to a new pair of glasses at our optical shop.

Examples of EyeMed and VSP

• Updating Eyeglasses: Mrs. Jones, a longtime VSP member, visited us for her annual eye exam and chose a sleek pair of frames from our collection. Her VSP plan covered the exam, provided a frame allowance, and discounted premium lenses with anti-glare coating. She left with glasses that were both stylish and affordable.
• Contact Lens Fitting: A new EyeMed member, Mr. Patel, wanted to try contact lenses for the first time. His EyeMed plan covered the fitting, provided an allowance for lenses, and offered discounts on follow-up evaluations to ensure a perfect fit.
• Diabetic Eye Exam: As a diabetic patient, Mr. Rivera uses his EyeMed plan to cover his routine eye exams. The tests include retinal imaging to monitor for complications, ensuring his vision and overall health are protected. If additional medical treatment were needed, we’d transition his care to his medical insurance.
• Eye Emergency: When Mrs. Carter experienced sudden redness and discomfort in her eye, she came to us for an emergency visit. While her EyeMed plan didn’t cover this issue (since it’s considered medical), we seamlessly billed her medical insurance, ensuring she received the care she needed without hassle.

Beyond Vision Insurance: Medical Visits to Your Eye Doctor

When your visit is a medical visit, for example if you have diabetes, glaucoma, dry eye, cataract surgery, or eye emergencies, vision insurance would not provide coverage. Any medical reason for the visit is billed to your medical insurance.

We are in-network with many commercial and government plans including:

• Aetna
• Anthem Blue Cross Blue Shield
• Connecticare
• Great West Healthcare
• Harvard Pilgrim Health Care
• Health New England
• Humana
• Medicaid
• Medicare
• Meritain Health – Aetna
• Multiplan
• Noridian Healthcare Solutions
• Oxford
• Railroad Medicare Beneficiaries
• Tufts Health Plan
• UMR
• United Healthcare
• Wellcare
• Cigna

Beyond Vision Insurance: Coordinating with Medical Coverage

Oftentimes there are overlaps with medical insurance and vision plans. For example your exam may be billed to medical, but your new glasses to vision. Our team at ReFocus Eye Health Bloomfield works closely with you to determine the right coverage for each service, minimizing out-of-pocket expenses.

For example:

• Routine Visits: Covered by EyeMed or VSP for vision care needs.
• Chronic Conditions: Covered by medical insurance (e.g., Medicare, United Healthcare) for treatment like glaucoma management or injections for macular degeneration.

Comprehensive Services with Your Vision in Mind

At ReFocus Eye Health Bloomfield, our services go beyond routine care to address all aspects of your eye health:

• Eyewear and Optical Services: A wide selection of frames and lenses to suit every style and need.
• Contact Lens Fittings: Ensuring comfort and optimal vision for new and existing contact lens wearers.
• Emergency Eye Care: Providing immediate treatment for injuries or infections.
• Diabetic Eye Exams: Monitoring and protecting your vision against complications.
• Advanced Treatments and Surgical Eye Care: Cataract surgery, glaucoma management, and corneal care led by experts like Dr. Kevin Dinowitz and Dr. James Pasternack.