Participating Providers
Vision Service Plan, Medicare, Eyemed, Blue Cross, Blue Shield of California, Cigna United Health Care, Medical Eye Services, and UCLA HMO.
We will also submit claims to other insurances for you if your insurance company allows us to.
If you are a returning patient, we will give a pass-code when you set up your appointment. You will use your unique code to access the form and your previous information.
Medical vs. Vision Insurance Medical Insurance is billed for medical issues such as eye infections, ocular surface disease or detection of a retinal detachment. If there is a medical problem causing a change in the vision we will bill the medical insurance. Vision Insurance is for routine eye health and vision exams with or without a change in the prescription. This insurance often covers part of the cost of glasses or contacts also.
Please note: Some medical insurance will provide vision coverage for glasses or contacts by subcontracting it to a vision plan. Please be prepared to give us information before your appointment regarding all of your coverage, as it may be difficult for us to sort it at your appointment time.
Medicare Guide for Eye Care Patients must pay an annual deductible toward any qualified health care before Medicare will pay for any services. After the deductible has been met for the year, Medicare will pay 80% of their “approved fee,” and the patient pays 20% as a co-payment plus any non-covered fees.
If the patient has supplemental insurance (such as Blue Cross) it may cover the cost of the deductible and the co-payment.
Our office will bill Medicare and accept payment directly from them if the services qualify for Medicare coverage (see exceptions below). Any charges that Medicare will not cover are payable by the patient at each visit.
Special exceptions:
- Medicare does not cover eyeglasses or contact lenses except some patients are eligible for 1 pair of glasses following cataract surgery. Ask our staff if you are eligible.
- Medicare does not cover the refraction part of the exam.
- Medicare does not cover any services unless we make a medical diagnosis. If your ONLY diagnosis is myopia (nearsightedness), hyperopia (farsightedness), astigmatism, or presbyopia, Medicare will not pay for any services. If there is a billable diagnosis, we will not know until the exam.