Eye Exam with the insurance Ny-Presbyterian?

Question

i have New York -Presbyterian Community health plan

and im supposed to go to the eye doctor this week to get contacts

but i allready went to the eye this year to get a new prescription for glasses a few months ago

but i dont have yearly check ups

so will the insurance cover this second exam?

Answer 1

I cut this from the handbook:

Eye Care

The covered benefits include the needed services of an ophthalmologist, optometrist and an ophthalmic dispenser,

and include an eye exam and pair of eyeglasses, if needed. Generally, you can get these once every two years, or

more often if medically needed. You just choose one of our participating providers. New eyeglasses (with Medicaid

approved frames) are usually provided once every two years. New lenses may be ordered more often, if, for

example, your vision changes more than one-half diopter. If you break your glasses, they can be repaired. Lost

eyeglasses, or broken eyeglasses that can’t be fixed, will be replaced with the same prescription and style of

frames. If you need to see an eye specialist for care of an eye disease or defect, your PCP will refer you.

They cover glasses every 2 years or more if medically necessary. They don't cover contact lenses at all. So, my answer would be no...

Here is the link to the handbook-see page 11

http://www.nyp.org/healthplan/pdf/medica...

Answer 2

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