What insurance do you accept?

We accept Medicare Part B and a number of commercial insurance plans and Medicare Advantage Plans, such as Keystone 65. Every insurer has multiple insurance plans, and every insurance plan is different. We will make every effort to verify your benefits prior to your visit and inform you of any anticipated copays or costs.

Please note, we do not currently accept Medicaid or Medicaid/Medicare combined plans, such as Keystone First, Aetna Better Health, UnitedHealthcare Community Plan, Coventry Cares Health Plan, AmeriHealth Caritas Pennsylvania, AmeriHealth Northeast, Health Partners, UPMC For You, Gateway, and Keystone Mercy.

Please call or email to ensure the most up-to-date list of accepted insurance plans. If your insurance is not currently accepted in our practice, we also accept self-pay via cash or check at the time of the exam. You may also be able to be reimbursed by your health plan by submitting to them a receipt for services through your out-of-network benefits.

Will my medical insurance cover an in-home eye exam? 

Medicare covers house calls for individuals who have difficulty leaving their homes to access medical care without a “significant or taxing effort”. Medicare patients are typically qualified for house calls if they have deficiencies in one or more of the following areas:

• Difficulty walking
• Dependence on a wheelchair or walker to ambulate
• Dependence on oxygen or difficulty walking due to shortness of breath
• Dementia or confusion making it difficult to see a physician in an office
• Require the assistance of someone to visit a doctor’s office

Do I need to pay a co-pay?

Many of the insurance plans we participate with require no out-of-pocket cost from the patient. Most medical plans cover in-home medical eye care under specialist coverage. If your plan requires a co-pay for a specialist visit, the co-pay is due at the time of the exam. 

What about deductibles and co-insurance?

If your insurance plan contains a deductible or co-insurance, you are responsible for payment according to the terms of your plan. For more information on health insurance deductibles, please visit https://www.healthcare.gov/glossary/deductible/.

Do you accept vision “insurance”?

All of our examinations are considered medical, not routine, and are therefore billed through the medical benefits of your medical insurance. We do not accept any vision plans, such as Davis Vision, VBA, VSP, Spectera, EyeMed, and others. These plans generally provide routine eye care in an office setting. If you choose to purchase eyeglasses, you may be able to submit your itemized receipt to your vision plan for partial or full reimbursement. Please check with your vision plan directly for more information.

I am homebound. How can I get glasses?

In most cases, medical insurance considers refraction (the “prescription” for eyeglasses) and dispensing of new eyeglass lenses and/or frames to be non-covered services. However, these services are available at an out-of-pocket cost. Please call us to discuss your individual needs and how our doctors can provide you with new eyeglasses.