The good news is that your Medical Insurance can be used when an eye-relatedmedical problem, such as eye pain, cataracts, dry eyes, complications from diabetes or high blood pressure (and many others) is the main reason for your eye examination. You do not need a vision benefits rider on your medical insurance to be covered for a medical eye condition. In these cases, your Medical Insurance will be billed for the eye exam even though a Vision Plan may also be in effect. Your Medical Insurance co-pays and deductibles prevail and must be paid at the time of your exam. Ultimately, you, as the patient, are responsible for being informed as to exactly what benefits you are entitled to through your health coverage. Your employer purchases a policy that they negotiated with the insurance carrier and sets the limits of your coverage. Through our experience, we may be able to help answer your questions, but we strongly advise that you check with your insurance company before visiting our facility. All copayments and deductibles are due at the time of your visit or when the Explanation of Payment is received. Unfortunately, in recent years, most insurance companies have been raising their copayments and deductibles to decrease their costs and raise yours.
We accept the following plans. If a referral is required, it is your responsibility to obtain it and to bring it with you.
Blue Cross/ Blue Shield
Blue Choice Senior Plan
Cigna POS, PPO Open Access Plus
Empire Healthchoice (BC/BS)
GHI Vision Services Plan
Oxford Medicare Advantage
Tricare PPO(not HMO)
How Do I Make an Appointment?
Will I Have To Pay Today? If you do not have insurance, you will need to pay for your services at the time of your visit. In most cases, you will be responsible for some payment at the time of service. Most insurance companies require a co-payment.
What Is A Vision Plan?
Some employers purchase a vision "rider" to your health insurance policy that allows routine eye care and often glasses or contact lenses. This is most often offered through another company, such as Davis Vision, VSP, CVC, NVA, or similar programs. If you have coverage for routine eye care through a vision plan, please specify this when making your appointment. This usually requires prior authorization from the vision plan, a voucher or a referral. This may take several days to obtain and cannot always be done on the day of your visit. Call your vision plan for more information.
Do I Need A Referral?
Always check with your insurance company first before making your appointment. To be safe, you should always bring a referral in case the doctor finds a medical diagnosis during your eye exam. If you know that you suffer from an eye condition, you will probably need a referral unless your insurance company does not use them.
What Is A Network Provider or Participating Physician?
Not all doctors are on all plans. When you make your appointment, tell us your insurance plan so we can tell you if we participate in your plan or you may have to pay IN FULL for the exam.