Central Coast Optometric Center is a participating provider for many insurance plans. The following includes some of the more common plans we accept. Please call our office if you don't see your insurance listed.
- VSP
- MESC
- Superior Vision
- CenCal
- Medicare
- Blue Cross
- Blue Shield
- Cigna
Medical vs. Vision Insurances
Why is insurance so complicated? The topic of insurance has always been a confusing one, especially in the world of eye care. We often see patients that carry both medical and vision insurances which cover different services. It is important for our patients to understand these differences.
Medical Insurance
Medical insurance is used if you have an eye problem, eye disease, or if any medical condition is present that causes eye problems. Some common conditions that must be billed through your medical insurance include:
- Vision loss
- Floaters
- Dry Eyes
- Macular Degeneration
- Allergies
- Infections
- Monitoring cataract development
- Examination of patients with diabetes
- Patients using medications with potential side effects
- Patients with glaucoma or who are at high risk for glaucoma development
Unfortunately medical insurance does not cover routine eye exams to check your glasses or contact lens prescription. Medical insurances will only pay for eye exams relating to medical complaints.
Vision Insurance
Vision insurance is actually a wellness vision benefit. It is designed to pay toward "routine" comprehensive eye examinations. A "routine" eye examination checks for, but finds no medical problems. The refraction (determination of the eye's prescription) is included, and since there are no medical problems, there is no discussion of problems or follow-up needed. Most vision insurance plans include the following benefits:
- Annual Vision exams
- Eyeglass frames
- Eyeglass lenses
- Contact Lenses
There is often no way to know prior to your exam what type of exam you will need or which type of insurance will be the right one to file your claim with. Our doctors will determine the appropriate type of exam and plan (medical or vision) to file your claim, based on the results of your exam. If we accept your vision or medical insurance we will file the claim for you. In the event we do not accept your insurance we will provide you with an itemized receipt that you may submit to your insurance for reimbursement.
Although our staff members are very knowledgeable about insurance plans, remember that it is not the doctor’s or staff’s responsibility to know the details of your individual plan. It is to your benefit to be aware of possible deductibles and co-pays that are part of your plan. Your insurance plan may cover routine vision care, but if your deductible has not yet been met, you will still have to pay for the service until your deductible is met. If you have both medical and vision insurance plans, our office will coordinate the benefits to minimize your out-of-pocket costs.
