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Insurance Benefits NOW! A Message from Dr. Smiley

Despite the warm beginning to October, this month marks the start of health care benefits election season.  I am often asked about which plans a patient should elect from their employer, or how one can best utilize their current year benefits before they expire.


For those of you that are Medicare eligible or have family members that are Medicare eligible, there are lots of choices out there, and with that comes much confusion.  Patients are often wooed by low premiums of Medicare Advantage plans, however, I would recommend against those. Patients seem to do significantly better with original Medicare plus a Supplement (Medigap).  By better, I mean less out of pocket expenses, and more importantly, you have the freedom to select health care providers of your choice.


Patients often forget that if their eyes are being monitored for a medical condition such as diabetes, cataracts, floaters, dry eye, etc. that medical plans do generally cover the eye health exams for these conditions.   For that reason, vision plans are best suited for individuals that like the convenience of an annual eye wellness exam, and they are especially helpful to families that have eyewear or contact lens needs.

I have seen many HR directors skimp on vision plans in an effort to offset some of the rising costs of the medical plans.   Unfortunately, there are many cheap plans that provide you as the consumer little to no benefit, reimburses your provider many times less than the wholesale cost for products, and at the same time the insurance company rakes in millions.  Some of these companies are UHC Vision (Spectera), Davis Vision, Superior Vision and many of the lower end EyeMed plans. For those of you with unsatisfactory choices, voice your concerns to your HR department, you can and (eventually) will make a difference!

As your eye primary care providers we are dedicated to not only optimizing your vision but to caring for the entire health of your eyes.   You see this in our office with advanced retinal scanning devices and other high tech devices. We are dedicated to keeping you seeing for a lifetime.  One of the biggest challenges we face with vision plans is our ability to integrate your vision care with your eye health care. For patients with eye health conditions such as diabetes, dry eye, floaters, etc. it is critical that your vision and medical plan play well together.   This eliminates separate visits, one for vision care and one for medical eye care.

While I generally don’t endorse a specific insurance plan we generally find that Vision Service Plan (VSP) “Signature" plans to offer the best value and benefit to patients with very little restriction of choices.   For those of you that are provided options, this is what I would recommend.


It seems at the end of the year there is a mad rush to get that elective surgery completed or get that last-minute doctor appointment.   PLAN AHEAD! I recommend completing your year-end healthcare needs NOW in October and November. School is in and many doctors have more mid-day availability and that means fewer waits.  If you have a remaining unused vision or flex spending benefits call us today to schedule your eye exam! We are seeing many of the late December appointment slots book up! DON’T WAIT! Get it done now and out of the way!!!! You will be glad you did and it will make your holiday season a little more stress-free!!!