Vision Insurance That Covers Medically Necessary Contacts

Vision Insurance That Covers Medically Necessary Contacts

Vision insurance is an important part of healthcare that helps cover the cost of eye exams, glasses, and contacts. However, some individuals may require medically necessary contacts due to certain eye conditions or injuries. In such cases, it becomes crucial for the vision insurance plan to cover the cost of these contacts.

In this article, we will discuss in detail the concept of vision insurance that covers medically necessary contacts. We will explore what medically necessary contacts are, which vision insurance plans offer such coverage, and how to determine if you qualify for this type of coverage.

What Are Medically Necessary Contacts?

Medically necessary contacts are specialized contact lenses prescribed by an eye doctor to manage or treat certain eye conditions. These conditions may include:

1. Keratoconus: A progressive eye disease that causes the cornea to thin and bulge outwards, resulting in distorted vision.

2. Corneal transplants: A surgical procedure where a damaged cornea is replaced with a healthy donor cornea.

3. Post-refractive surgery complications: Sometimes, patients may experience complications after undergoing LASIK or PRK surgery, which may require the use of specialized contact lenses.

4. Other eye conditions: Medically necessary contacts may also be prescribed to manage certain eye conditions like dry eye syndrome, corneal ulcers, and severe astigmatism.

Medically necessary contacts are not considered cosmetic and are often more expensive than regular contacts. Therefore, it is essential for individuals with such conditions to have vision insurance that covers the cost of these contacts.

Which Vision Insurance Plans Cover Medically Necessary Contacts?

Not all vision insurance plans cover medically necessary contacts. However, some plans do offer this coverage, and it is important to review your plan’s benefits to see if you qualify.

Here are some vision insurance plans that offer coverage for medically necessary contacts:

1. VSP Vision Care: VSP offers medically necessary contact lens coverage for individuals with certain eye conditions. The coverage includes a fitting evaluation, diagnostic evaluation, and two follow-up visits.

2. EyeMed: EyeMed offers medically necessary contact lenses for individuals with keratoconus, post-refractive surgery complications, and other eye conditions. Coverage includes both the contact lenses and the fitting exam.

3. Aetna: Aetna offers medically necessary contact lenses for individuals with certain eye conditions. The coverage includes a fitting evaluation, diagnostic evaluation, and two follow-up visits.

4. Davis Vision: Davis Vision offers medically necessary contact lenses for individuals with certain eye conditions. The coverage includes a fitting evaluation, diagnostic evaluation, and one follow-up visit.

It is important to note that coverage for medically necessary contacts may vary depending on the individual’s vision insurance plan and the specific eye condition being treated. Therefore, it is crucial to review your plan’s benefits and contact your vision insurance provider for more information.

How to Determine If You Qualify for Medically Necessary Contact Lens Coverage?

To determine if you qualify for medically necessary contact lens coverage, you need to consult with an eye doctor. The eye doctor will perform a comprehensive eye exam to determine if you have an eye condition that requires medically necessary contacts.

If you are diagnosed with an eye condition that requires medically necessary contacts, the eye doctor will provide a prescription for these contacts. The prescription will include the specific type of contact lenses required, the fitting requirements, and any other information needed to obtain coverage from your vision insurance plan.

Once you have the prescription, you can contact your vision insurance provider to inquire about coverage for medically necessary contacts. The insurance provider will review your plan’s benefits and inform you of any out-of-pocket expenses you may need to pay.

Conclusion

Vision insurance that covers medically necessary contacts is essential for individuals with certain eye conditions. Medically necessary contacts are specialized contact lenses prescribed by an eye doctor to manage or treat specific eye conditions. Not all vision insurance plans offer coverage for medically necessary contacts, and it is important to review your plan’s benefits to determine if you qualify. If you are diagnosed with an eye condition that requires medically necessary contacts, consult with your eye doctor and vision insurance provider for more information on coverage and out-of-pocket expenses.