PRIMARY EYE CARE
Exams that check refractive status (glasses prescription measurement, or ascertaining if glasses are needed) and offer preventative care to ensure lifelong eye health. A primary care exam is often very detailed, and commonly includes glaucoma testing (in adults) and a dilated exam of the eye's internal parts.At Campus Eye Center, our Optometric staff carries out most primary care exams. Optometrists specialize in refractive eye care (glasses measurement, contact lens fitting and troubleshooting) as well as providing full primary eye care.
ROUTINE VISION SERVICES
What is a refraction and why does my insurance not pay for it?
A refraction is a procedure performed by an eye doctor; one reason is to determine your prescription for eyeglasses. A phoropter, fitted with various lenses or trial lenses, is used to perform the refraction. This is the part of the exam where the doctor gives choices and asks questions such as, "which is better, one or two?" This is necessary because it helps the doctor determine if your vision can be corrected with glasses.Yet, a refraction is NOT just for an eyeglass prescription, which is just a by-product of a refraction. In reality, a refraction is a critical part of an eye examination. It helps the doctor determine whether one's vision is reduced by eye disease (cataract, macular degeneration, or some other problem). It helps the doctor follow the progression of cataracts and many other processes.
As dictated by the federal government, the refraction is a non-covered service that must be billed separately from the exam. Because Medicare ruled this service non-covered; many other medical insurance carriers have mandated the same policy. Based on this policy, Medicare, and therefore other medical insurance carriers require that YOU, the patient, are responsible to pay for this service separately from the remainder of the exam preformed by the doctor. Campus Eye Center requests payment for the refraction at the time of service.
Some times, refractions are covered by a SEPARATE, optional insurance, usually known as a "vision plan". Vision plans are like dental plans, in that some employers offer them to their employees as a benefit, while others don't. It is YOUR responsibility to determine if you have a vision plan that might offer coverage for a refraction. Unfortunately, many vision plans have restrictions as to how much coverage is provided, how often you may get a refraction, which practices participate with the vision plan, etc. At present, Campus Eye Center participates with very few vision plans. If you have a vision plan and are wish to take advantage of its coverage, please contact us with the name of your plan BEFORE your visit and we will try to determine if it can be applied to your visit with us.
