Networks

Eye Care Benefits Toolkit

Plan Design & Networks: Networks

Although access can vary widely among and within states, it is becoming more and more common to see doctors of optometry available in multiple locations in cities, small towns and neighborhoods. Optometrists can be found in major retail stores as well as vision care chains and as independent family eye doctors. The key question is: Are the optometrists covered in the network you offer to your employees?

The current distribution of eye care providers varies among health plans, which can affect access to services. If eye exams are covered under your medical benefits, ask your health plan about the number of doctors of optometry in the network.

Optometrists:

  • Serve as the primary care provider for eye health
  • Provide less expensive, conservative care while care from an ophthalmologist may start with more expensive surgical treatments
  • Provide office-based care while ophthalmologists may be hospital-based subspecialists

When looking at your overall provider network, ask the following questions to determine what type of network will best meet your needs:

  • Is there a good selection of network providers within close proximity of either your home or your workplace to serve eye care needs?
  • How long must you wait for an appointment with a network provider?
  • How much travel is required to visit a network provider?
  • Is your current eye doctor a member of the network?
  • Are network providers highly recommended in their communities?

When appropriate care is delivered through the right provider, cost savings are realized.