Please note that we do not accept the HMO version of the plans on the above list.
Routine Vision Plans
We can bill Medical Insurance for any examinations and treatments for visits that have a medical diagnosis. Examples would be eye infections, dry eye syndrome, and diabetes. Conversely, most Routine Vision plans will not cover these types of visits.
We can submit claims directly to BCBS PPO, Cigna PPO, Aetna PPO, Humana PPO.
Routine Vision is considered one annual visit for an eye health examination and a refraction (glasses prescription). Most Medical Insurance plans do not cover Routine Vision, but it is sometimes offered as an additional benefit (carved out or sub-contracted) to another company.
We can submit claims directly to VSP and Eyemed.
It is important to note that almost all medical insurance providers do not provide routine vision coverage. If you have both medical insurance and vision insurance, the medical insurance is “carved out” or sub-contracted to a separate vision insurance carrier. Sometimes one medical insurer may use several different vision insurance providers depending on what plan your employer chooses. So if you are coming in for routine vision, providing only your medical insurance company’s name does not provide enough information – we need to know both.
We do our best to contact your insurance provider(s) and find out if your coverage is active, what services are covered, if your deductible has been met, and what copays you will be charged. We are better able to estimate the charges you will be responsible for by verifying this information in advance of your appointment. Of course, we cannot guarantee coverage and may have to adjust your balance due as we receive Explanations of Benefits from your insurance company. Remember, you are responsible for all services and materials.
You will be responsible for paying for all services at the time they are rendered. We are more than happy to help you submit claim forms for reimbursement and/or complete any documentation you made need.
vs. Discount Plans
It is helpful to ask your HR department if your vision benefits are an actual insurance benefit or simply a discount plan. We honor both, but the coverage for an actual insurance plan is much higher than on the discount only plans.
Confirming Visionary as a Provider Online
When looking us up on your insurance company’s website to see if we are providers, be careful to check and see if we are listed as medical or vision providers. On medical plans, our name may show up on the list, but the patient may only be able to use us for one or the other, not necessarily both.
If your medical or vision plan is not listed as an Accepted Plan you may have out-of-network benefits. We are more than willing to submit a claim on your behalf or help you submit a claim yourself. However, payment for services and products will be required at the time of service or paid in full before product is released.
The patient is ultimately responsible for the cost of services provided and materials ordered. If your insurance company fails to acknowledge claims submitted, we will do all we can to help you. However, if we cannot resolve the issue after 30 days, you will be held responsible for these charges.
We require a social security number for any patient not paying their bill in full and in cash on the day that services are provided. This is the only way we can follow up if benefits are denied, charges are reversed or checks are returned for non-sufficient-funds.
Coverage for Glasses
Almost all Vision Insurance plans allow either glasses or contacts (very rarely will a company cover both, or occasionally a patient will have two plans, or they will have a plan and the spouse will have a plan and then they can get both). The benefit is usually larger on glasses because you get the savings on both the frame and the lenses, whereas if you use the benefit for contacts, you are only getting the lens benefit.
On top of that, if you use your benefits for contacts, it pushes back your entire material benefits for whatever period your company specifies.
In other words, if your company only allows you to get frames every two years, using your benefits towards contacts still pushes back your frame benefit for the full two years. They will not cover anything toward the patient's frames during that time.
Routine eye exams
Dry eye diagnosis and therapy
Pre- and post-operative care