Eye Care Insurance in Westerville, Johnstown OH and New Albany OH
In order to optimize your care at Professional Visioncare, we have compiled the following list of questions to help when researching your insurance program. We have provided phone numbers and websites for the insurances that we are providers for, to help you answer these questions.
Are our optometrists providers for your plan? If not, you will be responsible for full payment for your services and we will supply paperwork for your direct re-imbursement for the insurance company.
Our doctors are providers for the following insurances
- AARP (as an addendum to medicare)
- Medical Mutual of Ohio
- Medicare DME
- Medigold Vision (through VSP)
- Ohio Medicaid (Department of Jobs & Family Services, Healthy Start, Ohio Medicaid Primary)
- United Health Care & Affiliates
- Medicare Complete
- Vision Service Plan
- VSP Private Pay
- Value Vision
- Vision Plus
Is a pre-authorization necessary in order for your eye examination and materials to be covered?
- If so, what is the authorization number?
- Is there a specialized form & are you responsible for bringing it to your appointment?
What is your coverage for contacts, frames, and special lens materials?
Is your policy active, are you under a waiting period, or has your coverage expired?
Is your coverage every 12 or 24 months? Does your insurance renew every calendar year, the month of last service, or from the date of last service?
Will the visit be covered under your vision or health insurance plan?
Example: Annual eye exam – covered by vision insurance; eye infection- covered under medical/health insurance. If medical, are we providers for your medical/health insurance?
If you are a contact lens wearer, will your insurance cover any portion of the contact lens evaluation, fitting or materials?
Do you have a deductible amount for glasses/contacts, or specialized optometric treatment? Have you paid toward your deductible yet this year?
Do you need a referral from your primary care physician (PCP)?
Vision Insurance Programs
For Your Information: Most vision insurance programs will cover the cost of the annual exam and provide a benefit towards contacts or glasses. Contact lens fittings and evaluations are usually not covered, nor are medically necessary office visits. Please verify the limitations of your vision insurance coverage.
Vision Service Plan (VSP) www.eyefinity.com
This web page allows you to verify all of your coverage, and explains your coverage in detail, in an easy to follow print out. There is also a live online chat, email, or call 1-800-877-7195 Monday – Friday 5 a.m. to 7 p.m., Pacific Time, to speak with Member Servicesto verify your personal insurance coverage.
Vision Plus www.medben.com
In the Client Access section of this website a patient is able to request the necessary paperwork and authorized claim forms which should be brought to the office on the date of service. You may also check with your HR department for the correct forms.
- Email: email@example.com
- Phone: (800) 252-3447
Value Vision www.valuevision3.com
This website allows members to view the basic plan and explains the requirements for receiving benefits.
- Email: firstname.lastname@example.org
- Phone: 1-888-436-2720
Medical Insurance Programs
For Your Information: Medical insurance plans may cover the cost of procedures and testing related to a medical condition. They also will generally cover an eye exam if a medical condition is included in the findings. Many medical plans require that a deductible be met before the insurance company will pay. In this case the patient is responsible for payments until the deductible is met.
Medical Mutual of Ohio (MMOH) www.medicalmutual.com
This website allows you to view your policy and access coverage details, claim forms, and claim status reports.
United Health Care (UHC) www.uhc.com or www.myuhc.com
This web page allows you to verify all of your coverage and explains your coverage in detail. This site also has an online chat, where you can connect with nurses and customer service representatives directly to answer any questions you may have. Your Customer Service Number is listed on the back of your insurance card.
This website has everything you need to know concerning your medicare coverage and explanation of benefits. Medicare will cover 80% of your expenses for services. If you have a secondary insurance, Medicare will automatically forward any balance to them IF you have set this up with Medicare. Medicare does not cover contacts or glasses, except for one pair of glasses after cataract surgery.
- Phone: 1-800-Medicare
Ohio Medicaid http://jfs.ohio.gov/OHP/consumers/benefits.stm
If your insurance is Ohio Medicaid, both vision and medical needs will be serviced under your plan. This site outlines basic coverage. Please note that the rules governing annual eye exams & eyewear are as follows:
- For ages 0-20 & 60+ : 1 eye exam and 1 pair of glasses every year
- For ages 21-59 : 1 eye exam and 1 pair of glasses every two years