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Scleral lenses and Your Insurance Provider

When vision starts to become blurry, the immediate solution is to see an eye doctor and purchase a new pair of eyeglasses or contact lenses. In some cases, a person may elect for LASIK surgery, which comes at a much higher price tag.

On rare occasions, a patient may not benefit from wearing standard eyeglasses or contact lenses and is not a candidate for LASIK. These “hard-to-fit’ patients require a more advanced form of treatment like scleral lenses in order to restore their vision to normal. When patients discover they require more advanced vision correction, they have to face new challenges like adjusting to their new eyewear and, more pressing, the additional costs. We’ve put together some brief tips below to help our scleral lens patients take advantage of their insurances to reduce the burden and achieve visual success.

Medical Insurances & Scleral Lenses Owings Mills , Maryland

While our vision is vital for daily activities, many medical insurances are very restrictive in how they cover any service related to eyewear. Although medical insurances are used for specific eye care services, purchasing eyewear is often not covered — not even partially. Our practice can review with you the specific details regarding your medical insurance, and whether or not you can expect coverage for a pair of scleral lenses. In general, medical insurances are best used towards the eye exams and diagnostic measurements.

Vision Insurances and Scleral Lenses in Owings Mills, Maryland

Contrary to medical insurance, vision insurance plans are meant to reduce the costs for eyewear purchases. For some of our patients who have vision insurance with a contact lens plan, such as through EyeMed or VSP, a large portion of their scleral lenses will be covered. Please keep in mind that vision insurance policies differ. How much vision insurance will cover a specialty contact lens like scleral lenses is never concrete. Also, the experience of one patient may be totally different from the outcome of another patient’s experience.

This is why we recommend patients to schedule a consultation at our practice. We’ve seen many patients benefit a lot from their vision insurance plans, and we’ve guided numerous patients on how to maximize their coverage. Ultimately, we want our patients to enjoy the best possible vision for their eyes, and scleral lenses are often the solution.

One of the major reasons keratoconus patients and others with corneal irregularities come to our practice is precisely for our knowledge, experience, and expertise. Each specialty contact lens consultation will assess what are your visual needs and budget to develop the perfect pair of contacts. If you’re looking for scleral lenses and want to learn how your insurances can provide you coverage, call us today or schedule a consult online. So, in short…

Does a vision plan provide coverage for scleral lenses?

Under certain circumstances, when your case is medically necessary and when your vision plan includes medically necessary contact lenses coverage, then yes. But, without that coverage, you won’t receive coverage from a vision plan. Plans like VSP or EyeMed are known to provide coverage, but when your vision plan does not specifically include the medically necessary add-on, then you won’t get the coverage.

What do I do if I don’t have vision plan to provide coverage?

Come in for an eye exam & speak with our eye doctor. There are ways that we can help find out the status of your condition, understand the various options that you have even without a vision plan, and know how you can plan ahead for your future. Because our eye doctors carry years of experience and understand the needs of patients with corneal disease, you’ll have the information you need to make an educated decision.

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