Are You Trying To Figure Out Your Out Of Pocket Costs?
he costs of proper eye care can often be covered under a number of insurance plans. Traditional Health insurance policies will cover all or part of the cost of eye examinations when there is a medical complaint, but they do not pay for REFRACTIONS (the part of the exam which determines the eyeglass prescription of for routine “healthy” check-ups.
For that, many medical plans include a Vision Benefit Package that will cover all or part of routine regular eye health checkups as well as basic eyeglass frames and lenses.
Vision Plans are not all alike!
In order to control costs, all of the vision benefit plans negitiate for discounts from suppliers and providers.Some “funded” plans actually pay for a portion of the eyeglasses or contact lenses prescribed. But some companies go too far by limiting the selections to the plan administrators’ choices of frames, lens, or laboratories.
What Vision Insurance Plans Do We Honor?
OPTICS PLUS only participates in plans that allow patients the freedom to choose from our entire collection! We do have great frames that may be covered entirely by your plan, or you can take advantage of deep discounts (typically 20% to 40% off, depending on plan) if you opt for any upgrades and enhancements.
Under Medicare, eyeglasses may only be covered when prescribed after cataract surgery, and Optics Plus does participate in the Medicare and AARP United Healthcare plans.
There are some limitations:
- The eyeglass benefit is has a lifetime limit of one pair of eyeglasses, post surgery. We understand that vision changes can occur for some time after surgery so Optics Plus does apply its 6 month prescription change policy with no additional fees.
- The performing surgeon must also be a participating Medicare provider.
- The benefit provides a frame and one pair of single vision, OR bifocal lenses.
- Patients may be responsible for the Annual Deduction amount if applied to the claim.
- Patient may also opt for frame or lens upgrades that may not be covered by Medicare. Medicare recipients will get a 30% Discount on the additional fees.
- Some of these are simply discount plans, allowing a fixed percentage discount applied to aunty prescription purchase.
- For funded plans, the cost of basic frames and lenses will be applied to the patient’s total. Furthermore, discounts or reduced fees for non-covered options and upgrades will further reduce the final “Out-of-Pocket” expense.
Covered members are entitled to eye examinations AND eyeglasses every 2 years.
Like other plans, basic eyewear and services are fully funded.
Upgraded frames and lenses qualify for a discount (10%) PLUS credit and reimbursement that can total up to $275.00, which we apply to your order.
Out of Network
(The following plans impose unacceptable limitations on our choices for frame and lens vendors.)
- Davis Vision
- Superior Vision
- Patients qualify for 15% discount on prescription frame and lens purchases. (Contact lenses excluded)
- OPTICS PLUS cannot accept assignment for payment but will submit claims to be paid directly to patient, if the plan allows. Please check with your plan provoder to determine available benefits; these companies will not share your information with OoN Prviders.
OPTICS PLUS offers some great frame and lens packages and has some easy and affordable options that you can purchase including our popular Vernon Gantry promotion. Be sure to let us know your budget and we will work with you. Our team takes pride in helping you to find the perfect eyewear wardrobe for your budget and many of our clients find substantial savings by investing in quality eyewear that lasts far longer than lower priced options!