Insurance & Payment
Payment options
Our office accepts Visa, MasterCard, American Express, and Discover for your convenience. We do not offer payment plans.
Payment requirements
Exams, office visits & contact lens fittings and evaluations: Full payment or co-pay due at time of service.
Spectacles, contact lens orders: Half due at time of order and balance due upon pickup.
Accepted insurance plans
Due to recent ACA policy changes, always check with your insurance provider to ensure coverage. It is your responsibility to verify vision benefits with your insurance company before your visit. You have 15 days from date of service to inform us of insurance updates. Beyond 15 days, you are responsible for billing your insurance company.
Medical insurance plans accepted:
- Alliance
- Dean Care/Dean Care Gold/Advantage (except Focus plan)
- WI BadgerCare
- Quartz BadgerCare
- Dean Care BadgerCare
- Medicare, including any supplements
- Quartz HMO/Advantage
- Wisconsin Carpenters
- Wisconsin Laborers
- Wisconsin Masons
- Wisconsin Sheet Metal Workers
- WPS
Vision insurance plans accepted:
- EyeMed
- WI BadgerCare
- Quartz BadgerCare
- Dean Care BadgerCare
- NVA or National Vision Administrators
- VSP or Vision Service Plan
- Wisconsin Carpenters
- Wisconsin Laborers
- Wisconsin Sheet Metal Workers
***If you have a Medicare Advantage plan, please check with your insurance to see if you must see an in network provider to be covered.
Medical Insurance vs. Vision Insurance
Optometrists provide two basic types of health services:
- Functional vision care (which is sometimes called refractive or routine eye care), and
- Medical eye care
Functional vision care
Functional vision care includes routine eye examinations for eyeglasses, contact lenses, and health screening for eye and systemic diseases like cataracts, glaucoma, hypertension, and diabetes.
This type of service is usually covered by a patient’s vision care insurance.
Medical eye care
A patient may need medical eye care for:
- Eye infections like pink eye
- Eye injuries like metallic or wood foreign bodies, or
- Eye diseases like glaucoma, macular degeneration, and diabetic eye disease
This type of service is usually billable and/or covered by a patient’s major medical insurance.
There are also times when specific procedures or tests, such as visual fields, pachymetry and photos determine whether a disease is present or absent. These tests/procedures would also be billable and/or covered by a patient’s major medical insurance.
Both types of insurances may exclude some optometric services like contact lenses and contact lens evaluations. Some cover the exam fee, but not the cost of the materials, i.e. lenses and frames. Both types can have co-payments and/or deductible requirements.
We allow 60 days for an insurance company to respond to the claim.
If we do not get a response from the insurance company within 60 days or if the claim is denied, the balance will be transferred to the patient or responsible party. If we are not a provider for your insurance plan, we can issue you a paid receipt with dates of services, charges and diagnosis codes, which you can submit to your insurance company for possible reimbursement.