Health Care Reform
There have been many changes due to The Affordable Care Act. Most notably, insurance policies initiated after 2010 must provide preventive care, including routine eye exams, for children under the age of 19. Many plans for adults offer this exam with little or no co-pay. Medical visits and exams, where a medical eye condition is being monitored, may require a referral and/or be applied to your deductible. We accept all Exchange Plans, however, the exam may be applied to your deductible. Many policies are still changing, sometimes significantly, each year. Please check your policy before making your appointment.
Your insurance may also have a hardware benefit for eyeglasses and/or contact lenses. It is the patient’s responsibility to understand their coverage. Please bring your insurance card to your appointment and note that payment, including co-payment or any unmet deductible, is due at the time of your visit. We would be happy to help you if you have questions.
We participate with the following insurance companies:
- AARP MedicareComplete
- Anthem/Blue Cross Blue Shield
- Anthem Medicare Advantage Plans
- First Health
- Harvard Pilgrim*
- Health Plans
- Maine Community Health Options
- United HealthCare
*Patients are responsible for retrieving an authorization PRIOR to their appointment due to insurance changes. If there is no referral or authorization on file you may be liable for the full exam costs.
A word about Vision Plans
Although we do not participate with VSP, EyeMed, Blue View Vision, Cigna Vision or Davis, we offer a 20% eyewear discount to patients eligible for these plans. Patients may use their flex-spending account for all services and materials at our office. Most vision plans, such as VSP and EyeMed, offer out-of-network reimbursement. We will happily assist you with filing your reimbursement forms. Please contact your vision plan for more specific details.