Vision therapy is a personalized treatment program designed to improve visual skills and correct specific vision problems. If your eye doctor recommends vision therapy for you or your child, you’d be right to wonder if insurance will cover this treatment. The answer is that it depends.
Based on your insurance provider and plan, you may or may not be covered. It’s always advisable to contact your provider to determine your benefits and speak to your eye doctor about accepted insurance and vision plans.
What Is Vision Therapy?
Vision therapy is a personalized treatment program that uses exercises and tools to help improve visual skills and abilities. Think of it as physical therapy but for your eyes and brain.
While corrective eyeglasses or contact lenses help with conditions like nearsightedness or farsightedness, vision therapy addresses issues like eye coordination, lazy eye, double vision, or even visual processing disorders.
Vision therapy typically involves a series of eye exercises and specialized activities using therapeutic lenses, filters, prisms, and other technologies that are monitored and guided by your eye doctor. Each therapy plan is tailored to the patient’s needs, making vision therapy a focused and individualized approach to improving vision.
What Are the Benefits of Vision Therapy?
Unlike eyewear, which corrects your eyesight but doesn’t necessarily improve your overall vision function, vision therapy helps train your eyes and brain to work better together. This approach can result in significant improvements in everyday life, especially for children and adults dealing with conditions like:
- Amblyopia (lazy eye): Vision therapy can strengthen the weaker eye and improve its functionality.
- Strabismus (crossed eyes): Vision therapy helps align the eyes and improve coordination.
- Binocular vision dysfunction: Vision therapy helps resolve eye misalignment.
- Visual processing issues: Vision therapy assists with difficulties comprehending or interpreting visual information.
Does Insurance Cover Vision Therapy?
The answer is that it depends. Vision therapy falls into a bit of a gray area regarding insurance coverage. Here’s a breakdown of what you need to know.
Your Plan Type Matters
Coverage varies widely depending on whether you have private insurance, a vision plan, or government-provided insurance. Vision therapy isn’t covered by standard vision plans designed for routine eye exams, glasses, and contact lenses.
Diagnosis is Key
Vision Therapy is generally not covered by insurance. Coverage is only provided for medically necessary treatments, such as correcting lazy eye in children, addressing convergence insufficiency, or treating post-concussion vision problems. However, therapy aimed at improving sports vision or other non-medically urgent concerns will not be covered by insurance.
Preauthorization Might Be Required
Many insurance companies may require preauthorization, which involves your eye doctor submitting documentation to justify the need for vision therapy and outlining specific treatment goals.
How to Pay for Vision Therapy Without Insurance?
It’s important to understand the out-of-pocket costs if your insurance doesn’t cover vision therapy. Here are some alternate ways to pay for vision therapy:
- Health savings accounts (HSA) or flexible spending accounts (FSA): These accounts allow you to set aside pre-tax dollars to cover eligible medical expenses, which may include vision therapy.
- Payment plans: Your eye doctor may offer payment plans, so don’t hesitate to inquire about these options.
- Community or state programs: Check for local programs that may offer financial assistance for medically important treatments, especially for children.
How to Check if Your Insurance Covers Vision Therapy
Here is how to determine whether your insurance plan will cover vision therapy:
- Reach out to your insurance provider: Call the customer service line on the back of your insurance card and ask if vision therapy is covered under your plan. Be sure to provide them with any specific diagnosis codes your eye doctor has given you.
- Ask about requirements: If vision therapy is covered, ask whether preauthorization, documentation or a physician referral is necessary.
- Verify limits or caps: Clarify whether there are limits on the number of sessions covered or the dollar amount reimbursed.
- Discuss with your eye doctor: Your eye doctor may have the information and documentation you need to verify insurance coverage. They can also highlight why therapy is essential and provide you with a list of accepted insurance and vision plans.
See if Vision Therapy Is Right for You
Vision therapy can be an effective solution for various vision challenges, especially for conditions that are difficult to treat with glasses or contacts alone. Whether your insurance covers vision therapy or not, the potential benefits on your overall quality of life—and your child’s—are worth exploring.
Book an appointment with Verona Vision Care to discuss your concerns and how vision therapy could help you or your child. Our doctors can guide you through the process, from identifying your specific needs to checking your insurance coverage.
