Insurance Basics:

Our office accepts many common medical insurances and company-sponsored vision plans for your convenience. We’ll help you maximize any benefit. Our experienced staff are here to help answer any questions you may have.  If you need further help, please contact our staff.

We request that you have both your medical insurance and your vision plan information available to give to our staff when you make your appointment.  We look forward to helping you.

Understanding Well Vision vs. Medical Insurance Plans:

Often, when you make an appointment by phone, we can’t know whether your visit falls under your major medical or Well Vision plan until you have spoken with our doctors and your specific eye problems are evaluated.  So to gain a better understanding of standard insurance company rules that apply to eye examinations, please read the following information.

Well Vision Plans:

Vision plans provide coverage for wellness eye examinations, which are defined as those exams for which the only eye issue is blurred vision correctable with glasses or contact lenses.  The analysis, diagnosis, treatment or monitoring of medical eye conditions are specifically not covered by any Well Vision plan.

Medical Insurance Plans:

For patients requiring a physician eye report, or for those who have any important medical history such as diabetes, a thyroid condition, or if they are taking certain high-risk medications, such as Plaquenil, their eye exam is considered medical.  Conditions like cataracts, glaucoma, retinal conditions, a history of flashes or floaters, require a medically based eye evaluation.  Conditions like red, painful or scratched eyes, eye irritation, reduced or fluctuating vision, are also submitted to medical, not to Well Vision plans.

* * * * *

Co-payment amounts often vary among medical plans, and furthermore, from major medical plans to Well Vision plans.  Please be aware that we do not set the co-pays, deductibles, nor what conditions the patient may have.  We are the patient’s advocate in this process, and are interested in making the insurance paperwork process as simple as possible.