Primary vision care is a segment of total health and wellness strategies that encompasses health provider care for eye health and improved vision. There are numerous types of primary vision care as defined by insurance policies and providers alike. The most basic type primary vision care encompasses the provision of low-cost, affordable preventative care and refractive eye exams. Primary vision care may be provided by either an ophthalmologist or optometrist.
An ophthalmologist is a medical doctor who specializes in the eye and has been trained in pathology, disease, and treatment of the eye. An optometrist is a doctor of optometry and provides care as it relates to the primary vision and structure of the eye. Though both are professional health care providers that can provide vision care, they are two different types of doctors and the services of an optometrist are limited to vision care only.
As it relates to insurance, primary vision care is typically defined as routine refractive eye exams and may or may not include coverage for prescription glasses or contact lenses. Many health insurance policies include limited vision care, covering only one eye exam per year or every other year. Separate primary vision care plans that cover additional vision-related expenses may be available through employer-sponsored programs or can be purchased individually. Most health insurance policies do include coverage for ophthalmologic care, including eye emergencies, disease and other conditions affecting the eye.
Depending on the insurance policy, designation of a primary vision care specialist may be required for benefits. Other plans allow members to choose their own optometrist and ophthalmologist. Very few policies provide any type of vision care coverage for corrective vision surgery, except under extenuating circumstances such as legal blindness. Treatment for cataracts and glaucoma are normally covered under primary vision care policy.
While both types of eye doctors can serve as primary vision care providers, people with previous eye problems tend to choose an ophthalmologist to manage their eye care. Though an ophthalmologist can administer a refractive eye exam, some do not provide routine vision exams. There are also provider groups that consist of both types of doctors to provide all vision and eye health care under one roof, while others may operate under a colleague referral system and simply refer patients to the correct doctor for their needs.
Finding a vision care provider is fairly easy, but patients should check their insurance coverage and benefits before selecting one. Choosing a doctor who provides covered services as part of the insurance company’s preferred network of providers will ensure that out-of-pocket vision care costs remain as low as possible.