Contact lenses are considered elective when the user’s vision correction could be treated with eyeglasses, but instead they select the convenience of contact lenses. In most cases, vision insurance will only cover one or the other (eyeglasses OR contact lenses) during a benefit period.
What is the difference between necessary and elective contact lenses?
Non-elective contact lenses, also called medically necessary contact lenses, are prescribed by your optometrist to correct these types of eye problems, whereas elective contacts are chosen by the patient to correct an eye issue that eyeglasses or sometimes laser surgery can also correct.
What are non-elective lenses?
Non-elective contact lenses, also called medically necessary contact lenses, are prescribed by your optometrist. Your eye doctor will let you know if you need medically necessary contact lenses. These types of contacts are not covered by a VSP Individual Vision Plan.
What qualifies as medically necessary contacts?
Types of Contact Lenses
Medical necessity exists when there is an underlying medical eye disease or condition, such as keratoconus, corneal transplantation, corneal scarring, Sjögren’s Syndrome, ocular graft-versus-host disease (GVHD), neurotrophic keratitis, trichiasis, or Stevens-Johnson syndrome.
What are specialty contact lenses?
Specialty contacts are lenses that are designed for patients who have corneal conditions or other eye issues for which conventional contacts aren’t suitable. Since regular contact lenses sit directly on the surface of the eyes covering the cornea, it is imperative that they fit correctly and comfortably.
What is considered irregular astigmatism?
In irregular astigmatisms, the principal meridians are separated by any angle other than 90°, i.e., they are not perpendicular to each other. In this type, the curvature at each meridian is not uniform but changes from one point to another across the entrance of the pupil.
What is elective allowance?
Elective Benefits — when disability income policies allow the insured the option to take a specified sum for certain minor injuries instead of receiving the disability benefit. A schedule in the policy specifies the elective benefits available.
What does it mean if my child has a Anisometropia?
Anisometropia means that the two eyes have a different refractive power (glasses prescription), so there is unequal focus between the two eyes.
Can glasses correct irregular astigmatism?
Irregular astigmatism cannot be fully corrected with glasses, and sometimes not with soft contact lenses. Rigid gas permeable lenses are the best modality to correct irregular astigmatisms.
What is deemed medically necessary?
“Medically Necessary” or “Medical Necessity” means health care services that a physician, exercising prudent clinical judgment, would provide to a patient. The service must be: For the purpose of evaluating, diagnosing, or treating an illness, injury, disease, or its symptoms.
Does insurance cover medically necessary contact lenses?
Does medical insurance cover medically necessary contacts? No, your medical plan will not cover the fitting of contact lenses for medically necessary conditions; however, most vision plans do offer coverage.
How long can you keep in sclera lenses?
How long will a scleral lens last? Depending upon your tear film’s tendency to coat the lenses and your care habits, scleral lenses should last approximately as long as other rigid lenses (1-3 years).
Can a contact lens get lost behind the eyeball?
A contact lens getting stuck behind the eye is not physically possible; your eyelid is structured to prevent any objects from going to the back of your eye. … However, it is possible for both to get stuck and it’s wise to be aware that removing a soft contact lens is very different to removing a rigid gas permeable lens.
Are hybrid contact lenses expensive?
The price of conventional hybrid lenses is very comparable to soft multifocals or GP multifocals, so patients do not get “sticker shock” when outlining the costs associated with hybrid lenses.
Can contacts be too big?
It is not recommended to wear contact lenses with a different diameter from your prescription. If the diameter is too wide, the lens will be loose in the eye and may slip out of place. If the diameter is too small, the lens will have a tight fit, causing discomfort.