Each insurance company has multiple plans, which cover different services. Professional services covered by your insurance company are not determined by our office. They are determined by the contractual relationship between your employer and the insurance company. Some plans require referrals, some require that you use only doctors on a list.
It is your obligation to know the benefits and limitations of your insurance plan, not the doctors. The best person to explain the benefits of your policy is the benefits coordinator of your company. The insurance company responds to your employer since they pay the premiums. Our staff will do their best to help you get your maximum benefits. You are responsible for services rendered not covered by your insurance company which are medically necessary.
If you have the typical medical plan (indemnity, HMO, PPO, IPO) you should know that most eye care programs specifically “exclude refraction” and contact lens-related examinations. This means that the determination of your eyeglass and contact lens prescription are not a covered service. If you elect to have our office evaluate the fit of your contact lenses and/or change your prescriptions the fee is $95.00. If the contact lenses require refitting, additional fees will be determined by the complexity of the case.
If you have an HMO you cannot be seen without a referral. Referrals cannot be backdated. They are obtainable only from your primary care physician.
WHAT IS FLEX SPENDING?
Flex spending is a program created by the government which allows you to put away pre-taxed dollars in an account for use on medical care. Generally speaking, the money must be allotted the year before use, around November or December, and must be used by the end of the year. It has the advantage of allowing you to spend tax-free dollars. If used at the beginning of the year you also get a year loan without interest. A double benefit.
Do I Have Flex Spending? To find out if you have Flex spending consult your benefits coordinator.
What Can I Use flex Spending On? You can use flex spending on purchase of glasses, contact lenses, contact lens accessories, vision therapy, and/or refractive surgery.
Bring your glasses and any contact lens information (old prescription, bottles, or a box, etc.).