Illumineyes is OUT OF NETWORK with vision plans (VSP / Eyemed / Davis / Spectera)
But… we can still submit for your out of network benefits on your behalf. How does this affect the cost of my visit at IlluminEyes?
Eye Exams- Your visit may be covered by your medical insurance. We are IN network providers with Aetna, BlueCross BlueShield, Cigna, Harvard Pilgrim, Medicare, Health Plans, Humana, UMR, Unicare, and United Healthcare. Please call our office to check your coverage.
If you have no other insurance coverage, your visit is out-of-pocket (annual exams start at $125 and include retinal imaging). We submit for your out-of-network benefits and you receive a reimbursement from your vision plan in about 4 weeks. Typical eye exam reimbursements vary from $30-50. As an out-of-network provider, the difference in cost for your eye exam is about $30 after copays and retinal imaging costs.
Glasses and Contact Lenses- Combine our EyeQ Club prices with your out-of-network benefits for additional discounts. Our competitive EyeQ Club prices are usually within about $50 of what you typically spend with your vision plan. You pay for your glasses in full, we submit for your out-of-network benefits, and your vision plan reimburses you directly. Typical reimbursements: contact lenses ($100), single vision glasses ($150), progressive glasses ($200)
We hope this message finds you well.
After much thought and consideration to our patients and our practice, the doctors at IlluminEyes Vision Care have decided to change our partnership with VSP from IN-network providers to OUT-of-network providers.
This was a difficult decision for us to make because we know it impacts a significant number of our loyal patients. With honesty and transparency as a part of our core values, we would like to share why we've made this decision to change VSP to OUT-of-network providers.
Our commitment to you:
Our mission at IlluminEyes is to provide the highest quality eye care services and products. Unfortunately, under our previous contract with VSP, it has become increasingly difficult to do. For instance, in order to continue with VSP as IN-network providers, we would be forced to speed up your eye care to a “drive-thru”type experience: to see more patients in less time with less staff. It would become impossible to continue the same high level of care you expect from us and we are simply unwilling to compromise when it comes to our patients’ care.
Rising costs of vision care:
We take pride in our high quality products and services at competitive prices. In order to maintain this core value, we are now OUT-of-network providers for vision plans. This change in partnership is required because despite advances in technology and services, vision plan reimbursements have remained stagnant. The average eye exam reimbursement rate in the year 2000 was $35-50; in 2022 it is still $35-50.This no longer covers the cost required to provide the most up-to-date care.
How vision plans work:
Vision plans strive to be in complete control of eye care and they tend to ignore what is in the best interest of the patient.Unlike traditional health insurance, vision plans (i.e. VSP/EyeMed) are largely a discount program intended to promote the sale of eyewear affiliated with their OWN company. Vision plans offer benefits to members while also directly marketing to them to sell their OWN company’s frames and lenses. Vision plans support their parent company by restricting lens manufacturing to their affiliated labs and offering a larger discount for their ‘house-brand’ frame lines. They are in control of every step of production which limits both quality and efficiency. This control of production also increases the patient’s out-of-pocket expenses for eye care. Essentially, these restrictions prevent providers from offering the best eye care options to their patients, and in turn, strengthens the monopoly of vision plans (VSP/Eyemed).
The Vision Plan strategy ensures that they are profitable at all stages of eye care:
- Collect premiums from both the member AND the employer.
- Copays and out-of-pocket costs → vision plan passes additional expenses to the member
- Charge the provider material and service fees for frames and lenses (providers pay vision plans too!)
Vision plans are structured to support their parent company which makes it difficult for them to commit wholeheartedly to the patient. We, on the other hand, strive to provide only the best of care to our patients.
We reviewed how most of our patients used their vision plan benefits and we found that most were spending MORE on their eye care with vision plans versus what they would pay without it. The key difference in savings is that private-pay patients ONLY pay for services and materials when they need it. With your vision plan, you pay premiums whether or not you use the benefits. Many of our vision plan patients would actually SAVE on their eye care if they switched to private pay!
We encourage you to have a detailed conversation with one of our expert team members to review exactly how our change in partnership with your vision plan will affect you. As providers in tune with our patients' needs, we feel it’s time to put vision care back in the hands of our patients and eye care team. ,
The Doctors and Staff @ IlluminEyes Vision Care