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Is Vision Therapy Covered by Insurance?

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A young girl wearing eyeglasses is holding a string with colorful beads near her nose during vision therapy

Vision therapy is a specialized form of therapy designed to improve and enhance visual skills and abilities. It focuses on treating various vision problems and conditions that affect the way we see and process visual information.

  • While vision therapy has proven to be beneficial for people in our community, many might hesitate to try it due to financial concerns. A common question that arises is whether vision therapy is covered by insurance. Medical insurance may cover vision therapy. When it comes to your insurance, it’s important to talk to your insurance provider to understand what your plan offers.

If you think you may benefit from vision therapy, your eye doctor will be able to provide recommendations at your next appointment.

Understanding Vision Therapy

Vision therapy consists of a series of customized eye exercises and activities that are designed to strengthen and improve the coordination of the eye muscles and visual system. It is typically prescribed to treat conditions like:

Vision therapy is not a one-size-fits-all treatment. Each patient’s needs and goals are unique, and the duration and frequency of treatment may vary. Therefore, the cost of vision therapy can differ significantly from patient to patient, depending on their specific requirements.

Close-up page of an insurance coverage and a red pencil in the background.

Insurance Coverage for Vision Therapy

Coverage for vision therapy varies from provider to provider. Each insurance company has specific policies and guidelines that determine what treatments are eligible for coverage. 

Before starting vision therapy, it’s important to reach out to your insurance company and inquire about their policy. In some cases, your insurance may cover a certain percentage of the cost, while in others, they may not cover it at all.

When Your Insurance Does Not Cover Vision Therapy

If your insurance company does not cover vision therapy, there are still options available to make it more affordable. Many vision therapists offer payment plans and financing options to help make the treatment more accessible to their patients.

Programs such as Medicaid can provide financial assistance for medical treatments, including vision therapy. Vision therapy may also be covered if it is deemed medically necessary. If a patient has experienced a traumatic brain injury, stroke, or other related condition, vision therapy may be necessary to restore their visual function. 

It’s important to have a thorough discussion with your doctor and insurance company to determine if vision therapy is covered in such cases.

Key Insurance Points to Consider 

Whether or not vision therapy is covered by insurance depends on several factors, including the type of insurance plan you have, the specific vision-related issue you’re dealing with, and the policies of your insurance provider. Here are some key points to consider:

  • Type of Insurance: There are many different types of insurance, including medical insurance, vision insurance, supplemental coverage, and health spending accounts.
  • Prescriptions: Insurance providers may only cover vision therapy if it is deemed medically necessary. Take this opportunity to speak with your family doctor and your eye doctor about providing documentation and evidence that vision therapy is essential for treating your particular visual condition.
  • Out-of-Pocket Costs: Even if vision therapy is covered, you may still be responsible for certain out-of-pocket costs, such as copayments or deductibles. It’s essential to check with your insurance provider to understand your financial responsibilities.
  • Vision Insurance: Vision insurance plans often cover routine eye exams and eyeglasses or contact lenses. However, they may not always cover vision therapy. It’s crucial to review your vision insurance policy to determine if vision therapy is included.
  • In-Network Providers: Using an in-network eye care provider can help ensure that your insurance coverage is maximized. Out-of-network providers may not be covered, or you may incur higher costs.

Navigating Vision Therapy & Insurance Coverage

Investing in your vision health is a positive step towards improving your overall well-being, and vision therapy could be the solution you need. Talk to the professionals at Fontana Optometric Group today to learn more about vision therapy and vision therapy insurance coverage—we’re here to help.

Written by Dr. Jason Flores

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