Insurances

Medical Insurance

Aetna • AHCCCS • Allied

BCBS Centennial Care

BCBS NM • Cigna

GEHA • Gilsbar

HMA • Humana

NM Medicaid • NM Medicare

Presbyterian Commercial & Medicare

Presbyterian Centennial Care

Tricare • Triwest • United Healthcare

Western Sky Community Care

What is a medical eye exam?

A medical eye exam produces a diagnosis, like red eye, trauma, floaters, dry eye, glaucoma or cataracts, to mention a few. 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 to follow up on an existing medical condition are billed to your medical insurance plan. Specialist copays may apply.

Refraction fees

A refraction is the part of an office visit that determines your eyeglass and/or contact lens prescription. It typically involves questions like, “which is clearer – option one or option two” as different lens combinations are shown to you. Vision insurance policies generally cover both the eye exam and the refraction. Medical insurance will not cover the cost of the refraction.

Vision plans:

Davis • Eyemed • VSP

Sometimes has vision benefits:

Aetna • AHCCCS • Allied

BCBS Centennial Care

Cigna • GEHA

Gilsbar • HMA

Humana • NM Medicaid

Presbyterian Centennial Care

Tricare • Triwest

Western Sky Community Care

What is a routine eye exam?

A routine eye exam is defined by insurance companies as an office visit for the purpose of checking vision, screening for eye disease, and/or updating eyeglass or contact lens prescriptions. It will produce a final diagnosis relating to vision, like nearsightedness, farsightedness or astigmatism. There are normally annual limits on vision plan services.

Vision insurance plans provide coverage or discounts on routine exams, glasses and contact lenses. A routine eye exam is billed to your vision insurance plan. Exam and materials copays may apply. By law, Medicare does not pay for routine vision exams.

We try to accept insurances that will best serve our community. If your insurance is not listed, please call to see if we are planning to accept your insurance soon, if we can help you file for out of network benefits, or if there are private pay options that may help.

 

We can often help you figure out which insurance/plan you have based on common employer/carrier combinations with which we are familiar.

Ultimately, the plan is a contract between you and your carrier. There are limitations to the information we can obtain and it is the responsibility of you, the insured, to understand your coverage. Having a card/number on hand or reaching out to your HR department for correct information prior to your appointment is always recommended.

Our friendly and knowledgeable staff can often answer questions and verify benefits over the phone, so please call with questions and we'll be happy to assist as much as permitted.

Vision Plans

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