Insurance

Vision Care Plans

Vision care plans cover routine vision care and correction, including routine vision exams and refractions, basic eye disease screening, eyeglasses (lenses and frames) and/or contact lenses. Specific benefits vary by company and plan, and we can view and explain your eligibility.

We are proud to be in-network providers with with both EyeMed and Vision Service Plan (VSP).

We are out-of-network with the following vision benefit plans:

• Davis Vision direct reimbursement claim form

• National Vision Administrators out-of-network claim reimbursement instructions

• Spectera (United HealthCare Vision) non-network claim form

• Superior Vision (UniCare, WVCHiPS) member reimbursement claim form

• Vision Benefits of America out-of-network reimbursement portal

We can still see patients with these vision benefit plans as an out-of-network provider. We can help complete out-of-network reimbursement forms and offer our standard 25% discount on professional services for payment in full on date of service. If you’d like to pay for your exam in installments, we accept CareCredit and can help you apply for an account.

We can direct-bill a number of vision benefit plans that do not have provider networks, including:

• American Benefit Corp.
  (Putnam County Schools, Mountain State ESC)

• Benefit Assistance Corp.
  (United Methodist Conference, Kanawha County Public Library, City of South Charleston)

• Imagine360
  (Delaware North/Mardi Gras)

• Key Benefit Administrators
  (Thomas Health System)

• The Employee Benefit Service Center
  (City of Dunbar)

If you have a different vision care plan not listed, please contact our office. If you have vision coverage through your medical insurance and you’re not sure who provides your vision benefits, try calling the number on the back of your health insurance card or check with your human resources department.

We may be in-network for your medical insurance but not your vision care plan. For example, we are in network with United Healthcare for medical but out of network with Spectera, United’s vision care provider. We are in network with The Health Plan but out of network with Superior Vision. If you have Blue Cross medical insurance, you could have EyeMed, VSP, or Davis, and we are out of network with Davis. Call the number on the back of your medical insurance card to confirm your vision provider.

Medicaid

We are credentialed providers with West Virginia Medicaid, but routine vision exams are not covered unless the patient has vision benefits.

Adults: Most adults on Medicaid do not have vision coverage. Check your plan details.

Children: All children with Medicaid have vision benefits until age 21. We are in-network with VSP and out-of-network with Superior Vision. (Try using Superior Vision’s provider locator tool.)

• Direct Medicaid provides vision benefits directly

• Aetna Better Health of WV provides vision benefits through VSP

• The Health Plan provides vision benefits through Superior Vision

• UniCare provides vision benefits through Superior Vision

Self-pay for vision exams

Receive 25% off exam fees with payment at time of service

We see many patients who do not have vision coverage or come to us for routine vision care as an out-of-network provider on their plan. We are happy to help patients complete claims for out-of-network visits, and these patients are able to take advantage of our standard discount of 25% on exam fees for all payments made at time of service.