Our Services

Insurance & Payment
Request more information

PAYMENT OPTIONS and INSURANCE

Payment Options & Requirements:

  • Exams, Office Visits & Contact Lens Fits/Evals: Full payment or co-pay due at time of service. 
  • Spectacles, Contact Lenses, Orders: 50% due at time of order and balance due upon pickup. 
  • Our office does not offer any payment plans. 
  • Our office accepts Visa and Mastercard for your convenience.

Insurances:

Medical Insurance Plans Accepted:

  • Alliance
  • Dean Care HMO including Dean Care Gold
  • Medical Assistance or BadgerCare
    • Note: We are not providers for BadgerCare thru Unity and GHC.
  • Medicare and Medicare Fee for Service Plans
  • Physicians Plus HMO
  • Unity HMO
  • WEA
  • Wisconsin Carpenters
  • Wisconsin Laborers
  • Wisconsin Masons
  • Wisconsin Sheet Metal Workers
  • WPS

Vision Insurance Plans Accepted:

  • Medical Assistance or BadgerCare
    • Standard plan covers glasses with copay requirements.
    • Benchmark plan - self pay for glasses.
  • NVA or National Vision Administrators
  • VSP or Vision Service Plan
  • Wisconsin Carpenters
  • Wisconsin Laborers
  • Wisconsin Masons
  • Wisconsin Sheet Metal Workers

Vision Discount Plan Accepted:

  • WEA—Discounts Only

Medical Insurance vs Vision Insurance:

Doctors of Optometry ( optometrists ) provide two basic types of health services:

  • Functional vision care, which is sometimes called refractive or routine eye care.
  • Medical eye 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.

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 are indicated to determine if a disease is present or absent. These tests/procedures would also be billable and/or covered by a patient’s major medical insurance. Some medical plans, such as the HMO plans also cover one routine eye exam every calendar year.

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.

To complicate the matter further, not every optometrist accepts every available type of vision or medical insurance plan. Since all insurance policies are different, please check with your insurance company if you have any questions. If your policy does not cover a specific service or material, the patient (responsible party if patient is a minor) is responsible for the costs associated with the services and materials provided.
 
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, then 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.

Back to service list

Home | About Us | Our Services | FAQ | Links | Contact Us | Forms | Email to Friend | Site Map | Privacy |

2012. Created and maintained by WSI
This site is optimized for Internet Explorer 7, and Mozilla Firefox 1.5 or higher. Please download an updated version now.