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  • Doug Cook

Vision Care Plans

Each doctor in this husband / wife team graduated first in their class – summa cum laude (Dr. Doug in 1989 and Dr. Lisa in 1991).  Over forty percent of our practice is ocular disease management.  This includes glaucoma (with over 400 patients), diabetic retinopathy, macular degeneration and corneal diseases amongst other disorders.

As such, we may not see as many healthy eyes as other providers.  Vision care plans only cover some things (and nearly no coverage for disease-related conditions) and not many other options.  Unhappy encounters can occur with many of the bottom feeder type vision care plans when the doctor has to explain why their third party plan won’t cover what the patient assumed.

Patients build a trust with their eye care provider.  Patients assume if my name appears listed under a plan, we endorse or recommend it – which we can not.  For that reason, we are not members of the largest plan out there.

Vision Service Plan (VSP)

We carefully consider each plan whose offer appears on our desk.  We can evaluate the net benefit to the patient and the doctor.  Putting the numbers into a spreadsheet reveals a net pay as low as $8.50 per hour for the doctor.

If this rate of pay seems less than what you make at your job, you can understand why we are not providers.

You can be seen out of network with VSP.  They will reimburse you to see any eye care provider you choose.  We will provide you with a complete receipt, a form for filing reimbursement, and a stamped addressed envelope we can provide.

Bottom feeder vision care plans have their market, but they aren’t for every patient.

Which one is the best?

If you are seeking a plan, We would recommend Vision Care Oklahoma (also known as Vision Care Direct).  This nonprofit entity has a board of directors run entirely by optometric physicians – including Dr. Doug Cook.

Having trusted colleagues on the panel insures in our opinion highest quality of care with happy patients not upset that their plan covers a few things but leaves most items on as expensive copay upgrades.

Other plans

Other vision care plans we are providers include:

Vision Care Oklahoma / Vision Care Direct

Primary Vision Care Services

SoonerCare / Oklahoma Medicaid / Insure Oklahoma

Vision care benefits exist for children only through age 20. No adult benefits exist except for eye medical conditions.

Humana HumanaVision VCP

Blue Cross / Blue Shield

Note: some BC/BS plans farm out their vision care to other plans.  They do have their own plan for which we are providers.  The only way to know is to care the plan to find out.  We are on BC/BS managed panel but may not be on a panel if it is subcontracted to another plan.

We strive to offer an experience far better than what a lowest bidder can provide with your most important sense.

Checking Coverage 

There are over 60 different vision care plans.  Due to privacy policies, many plans have now eliminated the ability for doctors offices to call to check coverage.  These plans need a patient physically present or themselves call to confirm their coverage and discover if we are on that panel or not.  Don’t feel disappointed if we are unable to check for you due to these privacy policies.

Medical Eye Care / Health Insurance coverage

We are on many health insurance plans including Medicare, Most of the Medicare Advantage plans, Medicaid / SoonerCare / Insure Oklahoma and Blue Cross / Blue Shield. Other insurance plans may also help.

Traditional health insurance covers eye medical diseases such as glaucoma, cataracts, dry eye, ocular allergies.  They do not cover vision testing, testing for glasses, testing and fitting services for contact lenses nor the lenses themselves.  See our other post on Vision Care versus Eye Medical Care for more details on the differences.

When health insurance is applied it is because a diagnosis of an eye disease can be applied and is the reason for the visit.  Most insurance plans will not cover routine visits, annual checkups or complaints based on blurred vision resulting from a change in glasses prescription.

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