Insurances

We currently accept the large number of insurances listed below. Self- and cash-pay patients currently receive a significantly discounted rate if our practice is not currently enrolled as an in-network provider with their insurance.  Even if we are not an in-network provider with an insurance company, we accept the insurance's in-network fee schedule if they will accept a claim from an out-of-network provider, with very few exceptions. Some insurance companies, however, will not reimburse for an out-of-network provider. This is especially true of 3rd party brokers like Custom Design Benefits, Marpai, Medben, etc. Because of variable experiences with 3rd party brokers, we will need to be paid initially for those services by the patient and only refund them once the insurance company reimburses us for the services. 

Please note: we are not a vision services provider and do not participate in vision services programs or plans (VSP). But a patient with a VSP can still be seen at our practice. We perform complete eye exams that are billed under the medical portion of a patient's insurance.  If the visit is not covered by the patient's medical insurance, the patient will be expected to pay for the visit and then take the receipt and submit it for personal reimbursement with their VSP, which may pay all or only a portion of the billed amount. 

A note about refractions, which is the determination of the eye's state of focus, which is considered separate from the medical aspect of the visit. We will bill the insurance company, whose policies vary. Sometimes, depending on one's insurance, it is covered even under the medical portion of the insurance. In other situations, refraction is not covered at all, in which case, it will be billed to the patient, generally at the rate at which the insurance is known to reimburse for other members for whom  a refraction is covered. (Again, the patient can always submit the receipt for the refraction to their VSP for personal reimbursement). The only exception is Medicare of any kind, which does not reimburse for refraction at all, and for whom we do expect payment for the full refraction rate ($49), which is still less expensive than that charged by many practices or if the patient has to go elsewhere to get a separate optometric exam just to get the refraction for glasses.    

Insurances we accept:

• Aetna (since 8/15/2024)

• Anthem  Blue Cross/Blue Shield

• Buckeye Insurance

  • Allwell

  • Ambetter

  • Wellcare

  • Buckeye Advantage

• Cigna - we are currently not credentialed with Cigna due to delay on their end. Patients would be considered out of network, but the can still be seen in our practice.

• Custom Design Benefits 

• GEHA - government employee health care

• Humana

• Medicaid of Ohio

  • Amerihealth Caritas

  • Caresource

  • Molina

  • United Health Care Medicaid

• Medicaid of Kentucky

  • Wellcare of Kentucky is in progress

• Medicare (pure Medicare plus the following)

  • Aetna Medicare

  • Anthem Medicare

  • Humana Medicare

  • United Health Care Medicare

  • Secondary Supplemental Insurances for Medicare accepted include

    • AARP

    • Aetna

    • Anthem Blue Cross Blue Shield

    • Cigna 

    • Medical Mutual

    • Tricare for all

• Marpai

• Ohio PPO Connect

• United Health Care

• United Medical Group

• Credentialing with other insurance companies are ongoing.