120.989 Routine and Refractive Eye Examination:
It is MSSNY’s position that third-party payors make it abundantly clear to patients that eyeglass riders, routine eye examinations, vision care services, vision benefits, vision aid benefits, vision care benefits, eyeglass benefits and any such benefits, as desirable as they may be, do not substitute for a full medical eye examination on a regular basis by a qualified ophthalmologist, and that when eyeglass benefits are provided, that such benefits provide coverage for a refractive examination and prescription of eyeglasses by an ophthalmologist or optometrist of the patient’s choice. MSSNY will coordinate efforts with medical specialty societies to introduce legislation requiring third-party payors to use uniform and precise language to describe benefits provided in eyeglass benefits and riders, and make it clear to patients that such examinations do not substitute for a full medical eye examination on a regular basis. (HOD 1998-78; Reaffirmed HOD 2014; Reaffirmed HOD 2024)
