Insurance is a great way to make sure that you and your family can get the eye care you need without breaking the bank. At Professional VisionCare we accept many major medical and vision insurance plans.
Not sure what's covered by your insurance? Our eye care team would be happy to help you figure it out. Come see us today!
Eye Care Insurance in Lewis Center, Westerville & Johnstown, OH
Annual eye exams, prescription eyewear, and specialty eye care services can all add up quickly, hitting your wallet especially hard if you have a large family. Fortunately, vision and medical insurance are often effective ways of cushioning the blow a bit.
Medical Insurance vs. Vision Insurance
Vision insurance and medical insurance are not the same. Medical insurance plans protect you against paying too much in case of unexpected eye injuries or disease. Vision insurance, on the other hand, is designed to offset the cost of routine eye care for ongoing eye health, as well as prescription glasses or contacts and other vision-related services.
Have questions about whether your medical or vision insurance covers you with us? Contact our office, and we can help you figure it out.
Our Optometrists Accept The Following Medical and Vision Insurance Plans:
- AARP (as an addendum to medicare)
- Medical Mutual of Ohio
- Medicare
- Medicare DME
- Medigold Vision (through VSP)
- Ohio Medicaid (Department of Jobs & Family Services, Healthy Start, Ohio Medicaid Primary)
- OEHN/DML
- United Health Care & Affiliates
- Medicare Complete
- Vision Service Plan
- VSP Private Pay
- Value Vision
- Vision Plus
- Anthem
- Aetna
- Eyemed*
- BlueView Vision*
*We are providers for many Eyemed and Blue View Vision insurance plans. To see if we are providers for your plan, please contact us at (614) 898-9989 or email us at patientcare@ohiovisioncare.com.
**We also accept Medicare Planes that state “PFFS” (Private-Fee-For-Service) or “FFS” (Fee-For-Service) on their card.
Have questions about vision insurance and eye exams?
Want to do some research on your own? Here are the questions you should ask of your insurance provider to know how best to take advantage of your insurance plan. We’ve provided some links and other contact information below for popular providers.
- 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)
Go to this insurance site to verify all of your coverage, and see details about your covergae in an easy-to-follow print-out format. There are also live online chat and email options. Or you could call 1-800-877-7195 Monday – Friday 5 a.m. to 7 p.m., Pacific Time, to speak with Member Services and 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: customerservice@visplus.com
- Phone: (800) 252-3447
Value Vision
This website allows members to view the basic plan and explains the requirements for receiving benefits.
- Email: info@valuevision3.com
- Phone: 1-888-436-2720
Medical Insurance Programs
For Your Information: Medical insurance plans may cover costs related to a medical condition. They generally cover an eye exam if a medical condition is found. Many medical plans require a deductible be met before the insurance plan will pay. The patient is responsible for payments until the deductible is met.
Medical Mutual of Ohio (MMOH)
This website allows you to view your policy and access coverage details, claim forms, and claim status reports.
United Health Care (UHC)
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.
Medicare
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