Briffel Eyecare
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Insurance Plans
We accept many medical insurance and vision plans. Included medical plans are:

1.Aetna
2.Empire Blue Cross Blue Shield
3.The Empire Plan
4.Cigna
5.United Health Care/Oxford
6.GHI/Emblem
7.Medicare

Vision Plans:
1.Vision Services Plan (VSP)
2.EyeMed
3.Davis Vision

*Other plans may be available. Please check your insurance carrier and/or inquire within (516-431-3838). Plan participation subject to change. 

Vision Insurance
Understanding the Difference Between Vision Insurance and
Medical Insurance

It's no surprise that vision insurance is confusing to most people. Because vision insurance is
supplemental to regular health insurance, it's difficult to understand which benefits are included
and which ones must be purchased. Is there a difference between medical and vision insurance?

Routine vs. Medical Eye Exams

To understand the difference, one must analyze the different types of eye exams. Even though
office visits to an eye care professional are usually categorized as either "routine" or "medical,"
this terminology has nothing to do with the steps it takes to perform a comprehensive eye exam
nor the type of doctor who performs the exam. A comprehensive "routine" vision exam often
contains the same elements as a comprehensive "medical" eye exam, and seeing an
ophthalmologist or optometrist doesn't make the exam medical in nature.

The type of eye exam you have is determined by the reason for your visit or your chief complaint,
as well as your diagnosis. Routine vision exams usually produce final diagnoses such as
nearsightedness or astigmatism, while medical eye exams produce diagnoses such as
"conjunctivitis." Most insurance companies focus on the reason for your visit.

Understanding Your Coverage .

Insurance companies sometimes handle routine eye exams differently than medical eye exams.
Your medical insurance may cover a medical eye problem, but not pay for the exam if it is a
"routine" eye exam. Many vision plans provide coverage for glasses and contact lenses, or at least
give you some type of discount on the doctor's fees. Your medical insurance will pay for
examinations if you have eye health problems.

Many people with medical insurance have a separate rider policy to cover routine eye exams. To
complicate matters more, some medical insurance will cover one routine eye exam every two
years in addition to covering an eye exam that is for a medical eye problem. Study your policy
closely, as plan coverage varies among insurance companies.

What happens if you have concerns about your eye health but you also need new glasses? Can
you have your vision checked even though you have a medical eye problem? The answer, of
course, is yes. However, your eye doctor may charge you a refraction fee. Insurance companies
usually separate the components of an eye exam, one being the comprehensive exam and the
other being the refraction. Typically, vision insurance policies usually cover both the eye exam
and the refraction, while medical policies cover the exam only.

A Real-Life Example

Let's say your employer provides both types of insurance -- medical insurance as well as a
separate vision plan, such as Vision Service Plan (VSP). You decide that it's time for your annual
eye exam because your glasses are falling apart. You then see your eye care professional for a
routine eye exam and to purchase new glasses. Your doctor's office authorizes your benefits so
you proceed with the examination. At the end of the exam, your doctor informs you that in
addition to a minor prescription change, he found signs of glaucoma. You are instructed to return
in one week for additional tests.

Remember that your original reason for the visit had been to have an eye exam and to purchase
new glasses. Even though your doctor found signs of glaucoma at the end of the examination, this
visit would be covered under your "vision plan" because the main reason for the visit was to get
your vision checked for new glasses. But, because at the end of that exam you are considered a
potential glaucoma patient, your medical insurance will cover the additional tests and office visit:
related to the medical diagnosis of If glaucoma suspect.

When time comes for your examination next year, it is possible that you could use your medical
insurance to cover your examination, because this year it was determined that you could be at risk
for developing glaucoma. This serves as a medical diagnosis with your reason for the visit being
"glaucoma suspect." 

What You Should Know

Although most eye care practices are very knowledgeable about insurance plans, remember that
is not your doctor's responsibility to know the details of your individual plan. It is to your benefit
to be aware of possible deductibles and co-pays that are part of your plan. Your insurance plan
may cover routine vision care, but you might end up paying for it anyway if your deductible has
not yet been met.