Insurance Management

About our team!

Our experienced billing team is committed to managing your billing inquiries and insurance claims in a professional and timely manner. We will do our best to answer your billing-related questions and help you understand your health insurance benefits, payments and out of pocket expenses.

Our billing team understands that keeping up with insurance coverage is a complex process. Our experienced and knowledgeable team will help you work with your insurance carrier to ensure the maximum benefit for services rendered. If you have any questions regarding insurance, fees, or payment options, please feel free to contact our billing team. We are available to work with you to make financial arrangements and help you develop a plan to make your vision care treatment possible.

Spectrum Eye Care is a full-service practice with Ophthalmologists, Optometrists, and an on-site Optical Shop. Because we provide both medical and routine eye care, we accept a number of insurance plans to help cover the cost depending on your individual needs.

  • Medical Plans - We accept most Medical Plans. Please contact our office at (419) 422-6190 to receive more information.

  • Vision Plans - We accept Eye Med, Superior Vision, and VSP (Vision Service Plan). We also accept some vision plans not listed. Some restrictions may apply.

Vision Insurance vs. Medical Insurance

Your reason for being seen by the eye doctor and the results of your examination will determine whether your insurance company will classify the exam as “routine vision” or “medical.”

Vision Insurance is typically billed when you see an eye care provider for a routine eye examination. This may include checking vision, updating glasses prescriptions, and screening for eye diseases. Examples of a routine eye exam diagnosis will include nearsightedness, farsightedness, astigmatism, or presbyopia. Many vision insurance plans include some type of coverage or discounts towards a portion of your frames, lenses, or contact lenses. By law, Medicare does not pay for routine vision exams or refractions.

Medical insurance is billed when you see an eye care provider for a medical condition. For example diabetes, glaucoma, cataract, red eye, dry eye, etc. Depending on your policy, your medical insurance may cover a medical exam, but not pay for the exam if it is a routine eye exam. Examinations for medical eye care, assessment of an eye complaint, or follow-up on an existing medical condition are billed to your medical insurance plan.

Refraction is the part of the examination that determines your glasses prescription. This involves the use of special equipment and participation from the patient such as “Which is better 1 or 2” as different lens combinations are demonstrated. A spectacle prescription will be provided to you as a result of the refraction. Vision insurances typically cover a routine eye exam including refraction, medical insurances including Medicare will not cover the refraction.

If you have any questions about your specific vision insurance or medical insurance policies and benefits please call us and we would be happy to answer any of your questions.

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