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Eye Care & Vision Associates

Phone: 716-631-EYES

(716) 631-EYES

Patient Portal

Vision Coverage vs. Medical Insurance

What is the difference between Vision Plans vs. Medical Insurance?

At Eye Care and Vision Associates (ECVA) we offer comprehensive vision and medical examinations. How ECVA submits a claim for your visit depends on which provider you see.

If your appointment is with one of our Optometrists (OD) for a routine or annual vision exam, ECVA will submit a claim to your vision plan. Note, your medical insurance may contain a vision "rider."

If your appointment is with one of our Ophthalmologists (MD) ECVA will submit a claim to your medical insurance or health plan.

If you request ONLY a routine or annual vision exam, your appointment will be scheduled or rescheduled with one of our Optometrists (OD). If during the course of the vision exam a medical condition is found, your next appointment will be scheduled with an Ophthalmologist (MD).

The Optometrist (OD) will perform your "routine" or annual vision exam. If you have trouble with your vision (nearsighted, farsighted, astigmatism, etc.), your visit is considered a vision problem and will be billed to your vision plan. Vision plans may provide coverage or discounts for routine exams, glasses, and contact lenses. It is important that you understand that your Vision Plan benefits.

The Ophthalmologist (MD) is a medical doctor and provides services beyond a typical "routine" or annual eye exam. Examples of medical issues are:

  • Irritation or gritty
  • Styes
  • Headaches
  • Macular degeneration
  • Light sensitivity
  • Allergies
  • Infection
  • Corneal disorders
  • Diabetes
  • Lazy eye
  • Cataracts
  • Glaucoma or glaucoma suspect
  • Dry eye
  • Double vision
  • Trauma or injury
  • High risk medicine such as plaquinil

If you have or have had a medical issue and you see the Ophthalmologist (MD), your visit will be billed to your medical insurance. It is important that you understand that when your visit is with the Ophthalmologist (MD) and is done in conjunction with a routine or annual eye exam, ECVA will send a claim to your medical insurance. As such, you financial responsibility will be determined by your medical insurance policy.

Note, even if your visit is billed to your medical insurance, you can still use your vision plan benefits or discounts, if any, to acquire glasses or contact lenses from our Optical Shop!

With which Vision Plans does ECVA participate?

Vision care plans generally cover "routine" or annual exams along with eyeglasses and contact lenses.

  • VSP
  • EyeMed

With which Medical Insurance plans does ECVA participate?

Medical insurance must be used if your appointment is with an Ophthalmologist (MD) or Optometrist (OD) and you have or have had an eye health problem or a systemic health problem that has ocular complications (e.g., diabetes).

  • Blue Cross Blue Shield Plans
  • Medicare and Medicare Advantage
  • Independent Health (IHA)
  • Univera
  • Fidelis
  • Wellcare
  • Aetna
  • United Healthcare
  • Empire Plan
  • And, many others

Not sure which applies? Please call our Billing Office, 716-631-3937 x799.

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Four Western New York Offices

Elmwood Village

Map and directions to the Elmwood Village office of Eye Care & Vision Associates, Buffalo, NY

932 Elmwood Avenue
Buffalo, NY 14222
P: 716.884.0880
F: 716.884.0811

Southtowns

Map and directions to the Orchard Park office of Eye Care & Vision Associates, Buffalo, NY

3712 Southwestern Blvd.
Orchard Park, NY 14127
P: 716.648.5329
F: 716.648.3185

Niagara Falls

Map and directions to the Niagara Falls office of Eye Care & Vision Associates, Buffalo, NY

6917 Plaza Drive
Niagara Falls, NY 14304
P: 716.731.6434
F: 716.731.6439

Williamsville

Map and directions to the Williamsville office of Eye Care & Vision Associates, Buffalo, NY

811 Maple Road
Buffalo, NY 14221
P: 716.631.8888
F: 716.631.3803