Insurance & Vision Benefits Plans

We Accept Most Major Insurance & Vision Plans

We accept the following insurance plans:

• Vision Service Plan
• Eyemed
• United Healthcare
• BlueCross/BlueShield
• Aetna
• Cigna
• Medicare
• PHCS

If you have routine vision benefits covered under your primary medical insurance, we will be glad to submit for the exam coverage for you. You will owe any copayments upfront or the full charges if you have a deductible that applies that has not been met. It is our office policy that we only submit for the routine exam coverage. If you have hardware/materials coverage for glasses, contacts or contacts lens fittings, you will be responsible for those charges at the time of the exam and we will provide you a receipt for you to submit for reimbursement from the insurance.

Today's health care environment has become more confusing and complex. Understanding your health insurance and vision benefit is not as easy as it once was. Our practice has provided this information to untangle and clarify many misconceptions about third party care and your vision.

It is important for all patients to understand a fundamental principle of the third party mechanism. Unless your provider (doctor or health care facility) specifically takes assignment of benefits, the patient is ultimately responsible for any non-covered services and their charges. The insurance relationship is between the patient and the insurance company not between the patient and the provider.

Many common vision insurance programs only cover the vision part of the overall eye health examination. There are two distinct and important elements to every visit to our practice. First, the most important aspect of your visit today is to insure quality of life by providing you with a comprehensive, thorough medical examination of your visual system. Many eye diseases that affect your vision have little or no symptoms until the problem has become sight-threatening. Routine eye health examinations are critical to prevent debilitating eye disease. Secondly, each comprehensive medical eye exam will include a vision component to analyze and prescribe, if necessary, eyewear or contact lenses to correct your vision.

It may be necessary for your doctor to perform additional special testing to insure the overall systemic health of your eyes. Some of this additional testing may not be covered as part of your vision benefit. Payment for these additional special tests is the financial responsibility of each patient.

The following is a summary of VSP and Medicare vision plans. If you have further question please call our office.

Vision Service Plan (VSP)

In most cases, VSP will fully cover your eye health and vision exam. In some cases there may be a co-pay on the part of each patient. The co-pay must be paid at the time of service. The eyewear component of the Vision Service Plan contributes or subsidizes the purchase of your eyewear. Each specific Vision Service Plan subsidizes eyewear purchases at different levels. The Vision Service Plan is not an entitlement plan and patients are free to choose any frame or lens option recommended by their doctor. Our professional optical staff will be happy to determine if any out-of-pocket costs will be incurred by the patient.

Medicare

Our practice fully participates in the Medicare program. We accept assignment of benefits on behalf of each eligible patient. The eye health examination is a fully covered service under the Medicare program. However, as mandated by Federal law, the refraction part of the vision section of your exam is a non-covered service. Each Medicare patient will be charged (x) for the refraction. This charge must be paid for at the time of service during your visit.

Hopefully, this information will give you a better idea of the vision benefit you are using today. Our insurance coordinator is available to answer any questions you may have concerning your insurance coverage.

Thank you for your understanding and patience.