Does vision insurance cover virtual visits?

Virtual visits with your eye doctor are suddenly a lot more common during the coronavirus era, but is a telehealth consultation covered by vision insurance or health insurance? In many cases, the answer is yes.

EyeMed and VSP Vision Care, the two largest vision insurance plans in the U.S., detail virtual visit coverage on their websites.

EyeMed lists eye doctors offering telehealth services, but notes that you should call to make sure they are in your network and that your medical coverage will cover the virtual visit. Some VSP plans, including VSP Primary EyeCare and VSP Diabetic Eyecare Plus, cover telehealth services.

Some discount vision plans cover virtual eye care.

And in March 2020, the federal government expanded Medicare coverage to include telehealth visits, at least on a temporary basis.

Check with your eye doctor about the availability of virtual visits and whether your vision insurance covers telehealth.

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Coronavirus increases virtual visits

For many of us, the coronavirus pandemic has added a new word to our vocabulary — telehealth. What is telehealth? Via a secure video link, telehealth connects patient and eye doctor, enabling the eye doctor to conduct an eye exam or diagnose a vision problem.

Why have telehealth options increased in recent weeks? Virtual visits avoid in-person contact that could lead to the spread of the novel coronavirus, which causes COVID-19 disease.

“Social distancing is key to reducing the risk of infection,” says Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), a trade association for health insurers.

“Keeping people out of doctor’s offices and hospitals whenever possible will go a long way to help protect those who are vulnerable to the most dire effects of this virus.” Eyles adds.

SEE RELATED: Eye doctors switch to virtual visits to reduce spread of coronavirus

Insurers and virtual health care coverage

There’s no standard across U.S. private health insurers for coverage of eye care or health care via telehealth or telemedicine, virtual health care company Doxy.me notes.

Some of the country’s biggest private health insurers — including Blue Cross Blue Shield, United HealthCare, Cigna, Aetna and Humana — offer virtual health care options, but coverage varies from plan to plan

For instance, an insurer’s lowest-cost plan might not cover telemedicine, but its highest-cost plan might.

Amid the coronavirus pandemic, some private insurers have added to their virtual health care offerings or even are covering them at no cost, but there’s no guarantee those changes are permanent.

“Some insurance companies recognize the value of telemedicine and pay for it, whereas others aren’t quite there yet,” Doxy.me says.

Coverage of virtual visits for eye care also depends on where you live and what sort of service is involved.

Laws in 36 states and the District of Columbia require insurers to reimburse health care providers for telemedicine services at the same rate as in-person services. Laws in 21 states and D.C. provide similar reimbursement policies for Medicaid patients.

“We encourage everyone who needs to see a doctor during this time to please consider using telehealth or other technologies that allow you to consult with your doctor virtually — particularly if you are a senior, or someone with a disability or underlying health condition,” AHIP’s Eyles says.

The future of telehealth

Use of telehealth — and coverage by insurers — is expected to grow even after the coronavirus crisis eases.

A March 2020 poll by the Medical Group Management Association found 97% of medical practice leaders had expanded virtual health care access after the pandemic emerged. Experts predict health care practices will embrace long-term adoption of this technology. 

A March 2020 survey by Sykes, a provider of customer management technology and services, showed 52% of Americans were aware that their health insurers covered virtual health care services.

The Sykes survey also found 60% of Americans say the coronavirus pandemic has increased their willingness to use virtual health care in the future.

“This toothpaste is not going back into the tube. Telehealth will be the new normal after the coronavirus pandemic subsides,” Jon Pearce, CEO of Zipnosis, told Worth magazine.

HAVE QUESTIONS ABOUT YOUR VISION OR EYE HEALTH? Talk to — or virtually visit — with an eye doctor near you.

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