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Dry Eye Treatment Options Covered by Most Insurance Carriers

Posted by Dr. Danny P. Malone on May 18, 2016 8:30:00 AM

Treatment for dry eyes is usually covered under your major medical insurance and not typically covered under supplemental vision insurance. 

Vision Insurance vs Medical Insurance

health insurance benefitsYour supplemental vision insurance is meant to cover routine eye exams and prescriptions for corrective eyewear. Some vision insurance may even cover contact lens evaluation. Once you get outside those items, you’re generally covered under your medical insurance.

Typically medical insurance will cover dry eyes and other problems such as cataracts, injuries, and eye-related complications from other illness or disease. But there are many variations in coverage depending upon your policy.

As just one example of coverage details posted online, Aetna covers medications and most diagnostic procedures as well as punctual plugs. But there are some diagnostic approaches and treatments they consider experimental and won’t cover. Your particular coverage will need to be reviewed to determine what is and what’s not covered.

Medicare Coverage

Medicare does not cover routine eye exams unless you have diabetes, which requires an annual exam. It also doesn’t pay for eyeglasses or contact lenses. It does cover most tests and treatments for eye diseases including dry eye syndrome. If you have Medicare Advantage coverage there may be different coverage determined by your carrier.

Cost of Treatment

As with most insurance coverage, there are copays and out-of-pocket costs. Plus, as part of your treatment you may have prescription eye drops or other options. We can help you navigate all those aspects of your treatment and help determine the overall cost.

In my “Guide to Choosing the Perfect Optometrist I note under “Things to Look For – Office” that not only does the office need to be staffed with friendly and caring people and have a highly professional response and attitude, they also need to know how to handle your insurance coverage. 

The last thing you need in the middle of addressing your healthcare is financial concerns or spending time navigating a maze of insurance forms. 

Our experienced staff can work with your insurance carrier to determine what’s covered and what’s not. That’s a key part of what to look for when you’re choosing an eye doctor. 

Give us a call and let’s get started providing you superb vision care and treating your dry eye.

Use our contact form or call us at 972-612-2099.

Disclaimer: The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Guide to Choosing the Perfect Optometrist

Topics: dry eye, health insurance