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Vision insurance is a good way to reduce eye care expenses, especially if you are among the millions of Americans with some degree of vision impairment. According to the CDC, the cost of eye care prevents about half of Americans from seeing an eye doctor. In most cases, lack of adequate health insurance kept individuals from seeking care.
If you have health insurance, your policy may cover some vision services. However, it is important not to make assumptions about what is covered. Contacting a health insurance agent who will help you review your policy can prevent surprise bills if you need services later.
Your health insurance policy covers services that address medical conditions, including eye-related issues. For example, health insurance covers vision surgery for fixing a detached retinal or removing cataracts, but it does not cover routine eye exams and items such as glasses or contacts.
Vision insurance pays for a portion of expenses such as basic preventative care, including vision tests and eye exams. It also covers eyeglasses, including the lenses and the frames, and/or contacts. Depending on your plan, there may be additional benefits, such as coverage for daily disposable contacts.
Vision insurance does not cover eye surgeries. If your optometrist notices a medical problem during your annual eye exam, they will refer you to a medical doctor, such as an ophthalmologist, for further evaluation. From there, your health insurance would pay for treatment if it were deemed “medically necessary”.
Corrective surgery has become an increasingly popular choice for those with less-than-perfect vision. Despite its convenience and cost-saving benefits, corrective surgery is not medically necessary and is not covered by either your health or vision insurance. However, because it can ultimately save the insurance company money, many vision plans include discounts that may help you afford surgery.
If you wear glasses or contacts, the benefits of vision insurance are obvious – annual eye exams can be pricy, and depending on your prescription and eye health, corrective lenses can be a significant expense.
However, even if you have perfect vision, you should not skip eye exams. These exams can detect hidden medical problems, including brain tumors, certain types of cancer, high cholesterol, high blood pressure, thyroid disease or vitamin deficiencies. If you are under 40, current recommendations are that you visit an optometrist every five to ten years. As you get older, more frequent appointments are recommended.
If occasional routine appointments are all you need, then you probably do not need vision insurance. However, if you have poor vision or a family history of eye disease or a condition like diabetes that increases your risk of eye disease, vision insurance can save you money.
Vision insurance is generally affordable, but benefits and out-of-pocket costs vary widely. At Nevada Insurance Enrollment, our health insurance agents help you find the right plan for your needs.
If your health insurance company refuses to cover a claim, you have the right to appeal the decision and have it reviewed by a third party. Your policy should outline how to appeal a denial.
Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services.
A deductible is an amount you pay before the Insurance Company starts paying. Health insurance plans will have different deductibles. You’ll be expected to pay the whole medical bill out of your own pocket until you’ve paid your deductible.
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During the Medicare Annual Election Period (AEP), which is from October 15th through December 7th each year, many people may ask the question, “Do I want a Medicare Advantage Plan or a Medicare Supplement Plan (Medigap)?”
The Affordable Care Act / Obamacare, put specific enrollment periods in place to prevent people from only enrolling in health insurance when they were sick or needed surgery.
Even if you live in a state that requires health insurance coverage for fertility treatments, there may be certain requirements that you have to meet to have services covered. For example, if you have unexplained infertility, you might only qualify for in vitro fertilization after a period of time or a specified number of in-vitro cycles.
To be fair, in recent years, health insurance companies have made strides towards transparency. If you have an ACA-compliant plan, there are many services that your health insurance is legally required to cover, taking some of the guesswork out of budgeting for health expenses.