Multiple Sclerosis Community
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1532707 tn?1312159524

Don't have vision insurance but is opthamologist covered under my health plan?

I have BCBS group plan  but not any vision and I was thinking about going to the opthamologist to see about my eye cause they feel dry alot of the time despite artificial tears.  The other day I was just sitting on the couch and I saw stars. My MS started with optic neuritis but I thought it was a migraine and I never went to the doctor for it.
Is it covered? I think its not nescessarily vision but it does pertain to the eyes.
Whats your experience?
4 Responses
739070 tn?1338607002
If you go to an ophthalmologist then you are seeing an MD or medical professional. If you go to the little boutiques for eyeglasses that offer eye exams you are usually seen by an optometrist. The optometrist is usually what is covered in a "vision plan".

An ophthalmologist is a medical doctor and should be covered under the medical portion of your insurance. To be sure, call the  Customer Service number on the back of your card and they can tell you exactly which doctors are covered under your plan.  

If it were me, I would go see an ophthalmologist if you are having the similar symptoms to your optic neuritis, as before.  Let us know how things go.

1045086 tn?1332130022
Medical insurance will generally cover the expenses for an ophthalmologist's exam as it relates to a problem or disease specific to the eye.  It will generally NOT cover the cost of a refractive exam (checking your visual acuity and testing for prescription lenses to correct vision) even when the refraction is ordered as part of an exam based on a covered condition.

I'd call and ask your medical insurance representive to give you their best advise about coverage for each visit you're likely to have.

721523 tn?1331585402
I have BCBS.  I always see an MD to have my vision checked.  She lways puts that I have chronic dry eye and that she is checking for side effects of MS.  As long as there is a MEDICAL Dx on the billing, they cover it.  She also does my yearly sight exam and contack Rx at the same time.  It is always covered.  They will not pay for any contact fitting or glasses, but the entire exam is covered minus any deductible/co-pay!

I hope that this helps.  Always remind the Dr to include he medical Dx and it will be fine!

Best to you!
572651 tn?1531002957
I have BCBS and my eye exams by the opthamologist are covered by my insurance.  So are my husband's exam, and he does not have MS.  It is the glasses for us that is covered under a seperate plan.  Call and check, but you should be ok - especially as  long as you stay in-network.
best, Lulu
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