Insurance Plans Accepted:
- VSP (Scroll down for information)
- Medicare (Scroll down for information)
- Blue Cross/Blue Shield (Wellmark)
- Coventry
- United Health Care (Scroll down for information)
- Principal
- CIGNA
- Medicaid (Amerigroup)
- Sanford Health Plan
- EYEMED
- Aetna
- Most major insurance companies
Today's health care environment has become more confusing and complex. Understanding your health insurance and vision benefit is not as easy as it once was. Our office has provided this information to untangle and 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. There are two distinct and important elements to every visit to our office. First, the most important aspect of your visit is to insure quality of life by providing you with a individualized, comprehensive, and 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. Secondly, each individualized and comprehensive medical eye health examination will include a vision component to analyze and prescribe, if necessary, eyewear or contact lenses to correct your vision.
It may be necessary for Drs. Hansen, Pietigs, or Seelye to perform additional specialized testing to insure the overall systemic health of your eyes. The charges for this additional testing will be sent to your medical insurance for processing. If denied by your insurance, payment for these additional specialized tests will be the financial responsibility of the patient.
The following is a summary of the major Vision Insurance programs. Hopefully, this information will be helpful to all patients in choosing proper eyewear, contact lenses and eye health care for themselves and their families. Please feel free to ask for our Insurance Benefit Coordinator if you have any questions about your specific vision insurance or medical coverage during your visit. Our office number is 515.964.1671.
VSP
The 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 or subsidizes the purchase of your eyewear. Each specific Vision Service Plan subsidizes eyewear purchases at different levels. The Vision Service Plan is not an entitlement plan and patients are free to choose any frame or lens option recommended by Drs. Hansen, Pietigs or Seelye. Our professional 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 accept assignment of benefits on behalf of each eligible patient. The eye health examination is a 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 for the refraction. This charge must be paid for at the time of service during your visit. 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 in the office, by phone, or by emailing
Thank you for your understanding and patience.
United Health Care
Our practice participates with the medical portion of United Health Care (UHC). However, we are not in network with United Health Care vision plans, such as Spectera.
If you have a medical condition (diabetes, macular degeneration, pink eye, dry eye, headaches, floaters, glaucoma, or eye injury), we can use your UHC medical insurance for your exam. Should you not have a medical condition, we offer a discount for your exam and will provide you wiht a form you can send in to get reimbursement from Spectera.
Please call our office with any questions! We will make this simple for you and your family.
