Insurance Plans
Today's healthcare environment is often confusing and complex. We are providing this information to help clarify many misconceptions about third-party care and your vision.
Vision Insurance vs. Medical Insurance
Most routine visits to our practice are covered by your vision insurance. Shoreline Optometry doctors are poviders for Vision Service Plan (VSP). We also participate in the Medicare Program. However, vision insurance does not usually cover non-routine visits such as specialty diagnostic testing, or emergency eye care such as eye infections or injury. In these cases, we would need to bill your medical insurance.
Unless we specifically take assignment of benefits, you are ultimately responsible for any non-covered services and their charges.
VSP
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Vision Service Plan (VSP) - In most cases, VSP will fully cover your eye health and vision exam. In some cases there may be a co-pay on the part of each patient. The co-pay must be paid at the time of service. The eyewear component of the Vision Service Plan contributes to or subsidizes the purchase of your eyewear. Each specific Vision Service Plan subsidizes eyewear purchases at different levels.
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The Vision Service Plan is not an entitlement plan and patients are free to choose any frame or lens option recommended by their doctor. Our professional optical staff will be happy to determine if any out-of-pocket costs will be incurred by the patient.
Medicare
Our practice fully participates in the Medicare program. We do not accept assignment of benefits on behalf of each eligible patient. The eye-health examination may be a fully covered service under the Medicare program. However, as mandated by Federal law, the refraction (determination of eyeglass prescription) is a non-covered service. Each Medicare patient will be charged for the refraction at the time of service during your visit. There is no longer an eyewear benefit under the Medicare program unless the eyewear need immediately follows cataract surgery. The purchase of frames, lenses, lens options and coatings is the responsibility of each Medicare patient.
Medical Insurance Plans
We accept the following medical insurances (PPO only, we regretfully do not accept HMO):
We accept the following medical insurances (PPO only, we regretfully do not accept HMO):
- Medicare
- United Health Care
- Cigna
- Anthem Blue Cross of California
We hope this information will give you a better idea of the vision and medical benefits you are using today. Our insurance coordinator is available to answer any questions.
