Vision Plan Facts

If you have a Vision Plan, there’s a good chance GH Eye and Dr. Ally Stoeger are providers for your plan. We see patients who have Vision Service Plan (VSP), Eyemed, Davis Vision, Spectera and other vision plans.

One of the benefits for patients who have a Vision Plan is that whether they are examined at an optical store — or whether they are examined at a technologically advanced private practice like GH Eye — fees are determined by their VIsion Plan Benefits.   The bottom line is that patients are pleasantly surprised to find it costs about the same to have their eyes examined at GH Eye as it does to be examined at a big box store optical!

We’re fortunate to have a large number of patients tell us how much they appreciate having a private practice alternative.  

When national retail opticals and big box opticals first appeared on the landscape, the perception was that their prices on exams and glasses were much lower than private practice eye doctors.  But Vision Plans and other changes have leveled the field.   In fact, while private practice doctors have lowered many of their fees, some “discount” opticals have quietly raised theirs.  

If it’s been a while since you’ve had an eye exam by a private practice eye doctor, schedule your next appointment at GH Eye, and see the difference.

If you have a medical eye problem, we accept most medical insurance plans (Anthem, CareFirst BlueCross Blue Shield, Aetna, United Health Care, Medicare).  Vision Plans do not cover medical eye problems, but medical insurance plans do.

If you don’t have a Vision Plan, don’t worry —  just ask us how you can benefit from our GH Eye Club program! 

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her eye care practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.   

 

 

 

 

 

Do Vision Screenings Fail Our Children?

Although vision screenings pick up children who have vision problems, not all children with vision problems are picked up on vision screenings.  Screenings easily detect children who are myopic (near-sighted).  But children with significant vision and eye problems can pass a vision screening test for the following reasons:

1.   Screenings may fail to detect children who cannot sustain clear and comfortable reading vision.  A child can pass a distance vision acuity test, yet still have vision problems that affect learning.  Many of these children are so accustomed to eyestrain and reading difficulty that they do not realize they are having a problem.

2.  Vision screenings pass children with 20/40 visual acuity or better.  That may have been acceptable 50 years ago.  It’s not acceptable in the visually complex world we now live in.   For optimum clarity and comfort, I would want my children seeing 20/20 and not a minimal standard of 20/40.

3.  Screenings miss children with anisometropia (an example of this is a child that has one eye that is far-sighted and the other eye is astigmatic).  I’ve seen children with as many as 10 steps difference between the right and left eye who have passed vision screenings!  A difference such as this can affect visual clarity, comfort, sports vision co-ordination and driving safety. These children often end up suppressing the vision of one eye.  That’s a heavy price to pay for relying on a vision screening instead of an eye exam.

4.  Screenings can miss children with hyperopia (far sighted).  Because of the extra focusing effort these kids have to make in order to see clearly, they may have trouble concentrating on schoolwork or they may decide they don’t “like” to read.

5.  Screenings can miss children with amblyopia (lazy-eye) where the amblyopic eye is 20/40 or better.

6.  Screenings can miss children with intermittent strabismus (eye turn).  These kids are visually uncomfortable  because of the instability of their visual system.

7.  Screenings can miss children with medical eye problems.  Unfortunately not every healthy child has healthy eyes.

8.   Some kids with significant astigmatism can still pass a vision screening.

A few days ago we were examining a mom and dad who happened to bring their grade school child with them.  Since we had an opening in our exam schedule, the parents of this child decided to have her eyes examined also.  What we found was that this young child — who had passed pediatrician and school screenings –had six “steps” (1.50 diopters) of astigmatism in each eye. She even had mild amblyopia (lazy eye).  Fortunately,  we will probably be able to eliminate the amblyopia with the use of the proper glasses prescription.

Our office can help parents check their vision plan benefits.  Most vision plans cover adults and children.

80% of learning occurs using vision.  It makes good sense to make sure your child has the best possible vision and healthy eyes.  Eye exams can do that; vision screenings can’t.

Dr. Ally Stoeger provides annual eye examinations (including children’s eye exams), medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her practice at GH Eye has a superb collection of  basic and hi-tech lenses and the latest in fashion frames for adults and children.

 

 

 

 

 

Understanding Eye & Vision Insurance

There’s almost nothing more important to your well-being than clear vision and healthy eyes. And there’s almost nothing more important to your budget than making sure that you use your health insurance benefits correctly. Unfortunately, patients rarely understand how their eye and vision insurance works.  Here’s a quick two question quiz on this topic:

1.  Jessica is in pain because something got in her eye while she was out running.  She has medical insurance but because she doesn’t wear glasses or contacts, she elected not to take the vision plan addition to her medical insurance.  Which of the following is correct:

A.  Since Jessica does not have a vision plan, she does not have insurance coverage to see an eye doctor to remove the particle in her eye.

B.  She has eye coverage if she sees an eye doctor on her medical insurance plan.

Correct answer:   B

Vision Insurance generally provides for a once a year visit for a routine annual eye examination. It does NOT cover medical eye emergencies or treatment for eye disease.  However, your medical insurance — even if you do not have vision insurance-will typically cover a medical eye condition (assuming you have met your deductible).  

2.  Jeremy has a vision plan and a medical health insurance plan. His vision has gotten blurry  and  his eyes are frequently red and irritated. He had to stop wearing his contact lenses but wants a prescription for new contacts and glasses. Jeremy is concerned that he has recently started seeing floaters in his vision. Which of the following is correct:

A. Jeremy’s Vision Plan will cover his examination for irritated eyes, blurry vision, new contact lens prescription, eye glasses and floaters.

B.   Jeremy’s new glasses and contact lenses will  be covered by his vision plan.

C.  Because he has a vision plan he will not have any  charges for contact lens fitting services.

D.  None of the above.

Correct answer:  D  None of the Above.  

Jeremy has multiple medical eye problems (eye irritation and floaters) and multiple vision needs (eyeglasses and contact lens fitting). He may need two or three visits.  He would probably use his Vision Plan for one visit and  his medical insurance plan to cover additional visits related to the red eye irritation and floaters.  

If Jeremy uses his Vision Plan to purchase eyeglasses, he may have additional fees for glasses if he upgrades from the basic frame and lens choices provided by his vision plan.  And, if he used his VIsion Plan to purchase eyeglasses, in most cases he  would need to pay out of pocket for contact lens fitting / evaluation and for his contact lenses. If he uses his Vision Plan for contact lens fitting, he will need to pay out of pocket for eyeglasses.

Even though contact lenses are not covered under medical eye insurance, if you have a contact lens related complication that causes infection or eye pain, it may be covered under your medical insurance and not your vision plan.

And there are a few medical insurance plans that do cover an annual eye examination, even if you do not have a Vision Plan, and even if you do not have a medical eye problem.

GH Eye accepts VSP, EyeMed, Anthem, Care First, United Health Care, Aetna and other plans.  As part of our service to the community, we will help you research your eye and vision care benefits coverage.

For patients who do not have vision plans, or who want to fill in the gaps of their vision plan coverage, we offer our exciting GH Eye Club program.

Perhaps the most important aspect of care at GH Eye is that we co-ordinate your vision and medical eye care — both in terms of the examination services you need to protect and preserve your vision, and in terms of your insurance.   We care for your eyes AND your vision.

GH Eye is conveniently located for patients who live in Gainesville, Haymarket, Warrenton, Manassas and surrounding areas.  We have morning appointments available as early as 7 AM for early birds; late afternoon appointments and Saturday appointments.  Come visit!