Today's health care environment has become increasingly confusing and complex. Understanding your health insurance and vision benefit is not as easy as it once was. McConnell Eye Associates is providing this information to help clarify many misconceptions about third party care and your vision.
It is important for all patients to understand a fundamental principle of the third party mechanism. Unless your provider (doctor or health care facility) specifically takes assignment of benefits, the patient is ultimately responsible for any non-covered services and their charges. The insurance relationship is between the patient and the insurance company, not between the patient and the provider.
Many common vision insurance programs only cover the vision part of the overall eye health examination. McConnell Eye does NOT accept vision insurance but instead accepts Medicare and most private health insurances. The most important aspect of your visit is to insure quality of life by providing you with a comprehensive, thorough medical examination of your visual system. Many eye diseases that affect your vision have little or no symptoms until the problem has become sight-threatening. Routine eye health examinations are critical to prevent debilitating eye disease.
It may be necessary for your doctor to perform additional special testing to insure the overall systemic health of your eyes. Some of this additional testing may not be covered as part of your insurance plan. Payment for these additional special tests is the financial responsibility of each patient.
Hopefully, this information will be helpful to all patients in choosing eye care for themselves and their families.
Our practice fully participates in the Medicare program. We also accept most private insurances. We accept assignment of benefits on behalf of each eligible patient. The eye health examination is a fully covered service under the Medicare program. However, as mandated by Federal law, the refraction part of the vision section of your exam is a non-covered service. Each Medicare patient will be charged $65 for the refraction. This charge must be paid for at the time of service during your visit. Unless, immediately following cataract surgery, there is no longer an eyewear benefit under the Medicare program. The purchase of frames, lenses, lens options and coatings is the responsibility of each Medicare patient.
Hopefully, this information will give you a better idea of the vision benefit you are using today. Our insurance coordinator is available to answer any questions. Due to the large number of different Vision Insurance Benefit Programs, it is impossible to know the specific details and reimbursement policies of each. If our doctors do not participate in your Vision Benefit Program, we will be happy to provide you all the necessary forms and documentation for you to submit to the carrier for reimbursement.
Thank you for your understanding and patience.