Planning For Your Visit

Insurance

When preparing for an exam many individuals have inquiries regarding insurance coverage. There are two types of insurance that can be filed in our office–vision insurance and medical insurance.

VISION INSURANCE plans help with coverage for glasses and/or contact lenses and a general eye health screening. Vision plans typically provide a hardware discount toward glasses OR contact lenses. Most vision plans have a set copay for a glasses prescription + general eye health screening and a second copay required to be fit in contact lenses–this copay is required for each year you are fit in contact lenses–even if there has been no change to your contact lens prescription.

If any medical conditions or concerns are noted during an eye examination (diabetes, certain medication use like Plaquenil, dry eye, glaucoma, cataracts, macular degeneration, eye infections, redness, flashes/floaters, etc.) vision plans typically do not provide coverage for additional testing, treatment, or follow-ups as these conditions are deemed medical and therefore examinations and testing should be billed toward your medical insurance plans.

MEDICAL INSURANCE plans help with coverage for medical conditions, they do not cover updating glasses or contact lenses. Many medical insurance companies partner with vision insurance plans to provide their clients with additional vision benefits–if you are unsure of who your vision insurance provider is you will need to contact your medical insurance company or HR department through your job.

If you only have medical insurance but no vision insurance you can still get a glasses and/or contact lens prescription. Individuals with only medical insurance who wish to update glasses prescription have a refraction fee ($30) for the doctors to update a glasses prescription. Contact lenses can also be fit for an additional fee depending on an individual's prescription/type of lenses worn.

Accepted Vision Plans

Not Accepted Vision Plans

  • Eyemed
  • Spectera
  • Superior Vision
  • Davis Vision
  • FEP BlueVision
  • United Healthcare Vision (UHC Vision)
  • Primary Vision Care Services (PVCS)
  • Soonercare Vision Plans

Accepted Medical Plans

Will Be Responsible For Refraction ($30) and Applicable Specialist Copay and Deductibles

  • Medicare
  • Soonercare (Aetna, Humana, Complete Health)
  • Blue Cross Blue Shield
  • Blue Cross Blue Shield Medicare Advantage Plan
  • Humana
  • Humana Medicare Advantage Plan
  • GEHA
  • Aetna
  • Healthcare Highways
  • United Health Care
  • United Health Care Medicare Advantage Plan

**Not a comprehensive list, call office for further inquiry if your insurance is not listed above**

Tricare Benefits

Midwest City Eye Care Associates is the proud preferred partner of Tinker Air Force Base and are honored to take care of our veterans and active duty family members. Tricare exam coverage varies depending on plan. Tricare does not currently provide hardware benefits (glasses or contact lenses -unless through a vision plan), but our office is thrilled to provide discounts to our service members and families.

Tricare Prime Active Duty

For family members only-not the enlisted member
Vision: Vision Examination with Glasses Prescription every 12 months (1 year) + 1 Day
Medical: Can be seen with a referral from primary care physician - no cost share

Tricare Prime Retired

Vision: Vision Examination with Glasses Prescription every 24 months (2 years) + 1 Day
Medical: Can be seen with referral from primary care physician - subject to cost share

Tricare Reserve Select

Vision: Vision Examination with Glasses Prescription every 12 months (1 Year) + 1 Day
Medical: Can be seen without referral - subject to deductible

Tricare Select Retired

Vision: No benefit
Medical: Can be seen without referral - subject to deductible

What to Expect from Your Exams

Our doctors put ocular health needs first, our reviews often note how comprehensive our exams are! Therefore please plan on spending about an hour to an hour and a half in our office.

When you arrive at your exam you will be greeted by a friendly staff member who will ask you to fill out paperwork regarding your demographics and medical history. Please bring a copy of your medical insurance cards (not vision, but medical) and a list of your current medications.

You will then be screened by one of our kind technicians before seeing one of the doctors. Our technicians work diligently to provide a cost estimate of your exam based on the insurance information you provide prior to getting too far along in your visit so that you know what to expect at check out. To help streamline this process please bring your most recent pair of glasses and/or pictures/boxes of your current contact lenses.

Next the doctors will perform a comprehensive health and vision exam. They will provide you with a copy of a glasses prescription and, if desired, a contact lens prescription as well. Our doctors do prefer to dilate our patients, as dilation is considered standard of care. Dilation is always an included service in your exam at the initial time of service.

Dilation is a procedure in which drops are instilled to each eye that enlarge the pupils so that the doctors can look at the inside of the eye. Dilation is an important aspect of the exam as it allows for detection of glaucoma, macular degeneration, retinal tears/detachments, bleeding related to systemic conditions such as glaucoma, hypertension, blood clots, etc., and more. Side effects of dilation include blurry vision up close and light sensitivity for 2-6 hours after drops are instilled. Dilation typically does not affect distance vision and therefore most patients feel safe to drive home afterwards, however if it will make you more comfortable we do recommend bringing a driver with you to your appointment.

At the conclusion of your examination, the doctor will review any abnormal findings with you, answer any questions you may have, and provide you with copies of your prescription(s). If you would like to purchase glasses with our office we then have wonderful opticians who will welcome you to our optical and help you find the perfect pair of glasses that are not only stylish but also within your budget.

Please Note: Contact lenses are a separate medical device that requires additional time and examination to ensure proper fit, comfort, and vision. Therefore, if you are interested in contact lenses (whether you have worn them in the past or present) there is an additional copay for fitting services. If you are interested in contact lenses please let your doctor know at the beginning of your exam and they would be more than happy to discuss contact lens options with you.

FAQs

Insurance/Payment Questions:

Do I have to have vision and/or medical insurance to be seen?

No! Our office provides private-pay savings to individuals without insurance so they can still keep their eyes healthy with an affordable exam rate.

I really like your office, you take my medical insurance but not my vision insurance. What can we do?

Given you have a medical condition, we can file your exam to your medical insurance. If you wish to get glasses/contact lenses with us we can provide you with an itemized receipt that you can submit to your vision plan to see if they will reimburse some of your expenses or we can give your copies of your prescription to take to an office that does accept your vision plan for hardware benefits.

Do you offer payment plans?

Yes! Our office is happy to provide financing options through Sunbit. Sunbit is a third party program that approves 90% of applications. All 3 month Sunbit payment plans have 0% interest, payment plans greater than 3 months are subject to interest that varies by credit score.

Do you offer payment plans?

You can click the following link or scan the QR code: https://apply.sunbit.com/MidwestCityEyeCareAssociates/?utm_source=posqrcode for more information and to get started. Essentially you’ll provide information and Sunbit will pre-approve you up to a certain amount. It will then show you different payment plan options and interest rates–you can decide what works best for you!

Prescription/Glasses Questions:

How long is my contact lens/glasses prescription good for?

1 year (365 days) from your exam.

If I get a pair of glasses and decide I don’t like the frame I picked out, can I return my glasses?

No. Glasses are a custom made product specifically for your eyes, once the order is submitted to the lab we cannot cancel it. Some vision insurance plans will allow you to do a frame restyle within a certain time window but that would be subject to a case-by-case basis.

How long do I have to wait to get my new glasses?

Average turnaround time with our office is 10-14 business days. We do NOT have the ability to provide same-day glasses, but can provide a prescription for you to take to a place that does if you so wish.

What are the benefits of getting glasses through your office and not online?

We have several reasons!

  • Our opticians are some of the best in the trade! Our staff is well trained on fit, comfort, and lens designs. They will help you choose the best pair of glasses for your lifestyle, aesthetic, and in your budget.
  • Being able to try glasses on in-person allows for the most accurate test of comfort, color, style, and fit–we want you to love your new frames!
  • Glasses are a custom product, many measurements go into ensuring a good fit. Your glasses need to be properly aligned on your face to ensure the lenses are made to align your eyes with the optical center of the prescription–if things aren’t lined up quite right (even 1 mm can make a big difference!) It can result in blurry or double vision.
  • Our frames all come with a 1 year manufacturer’s warranty–if your frame breaks just bring us all the pieces, as long as the frames haven’t been glued or chewed on we’ll get them warrantied!
  • Lastly, a 2018 study performed by the American Optometric Association (AOA) stated that 44.8% of glasses online were made incorrectly or had safety issues– is it worth the 50/50 chance of getting what you ordered?
I have an old prescription (>1 year), can I bring it in and get glasses made?

Unfortunately not. We cannot legally fill a glasses prescription that is expired. It is important to have your vision checked so that your glasses are correct, we’d hate for you to spend money on a pair of glasses you won’t see well out of or could see even better with if you’ve had an undetected vision change!

General Exam Questions:

What is the difference between dilation and retinal photos?

Dilation is considered standard of care–it allows the doctors to evaluate the entire retina using lights and lenses. Retinal photos provide a more detailed view of the retina–and therefore are an invaluable tool–however they cannot see the far peripheral retina. For this reason, insurances will cover a dilation with a comprehensive examination without an additional cost to you, however they consider retinal photos an elective procedure. Therefore, photos have a cost of $30 unless there is a medical condition (diabetes, glaucoma, macular degeneration, retinal nevus/freckles, etc.) that your medical insurance can be billed for, whereas dilation is included at no additional fee to you at time of service.

If I do retinal photos do I have to be dilated?

Retinal photos provide great information to the health of the eyes, but they do not allow the doctors to see everything. We recommend retinal photos be used as a screening tool–if everything looks good on your retinal photos, doctors may say it is OK to defer dilation to the next year, however dilation should be performed on a regular basis to ensure everything is healthy with the eyes.

Why do contact lenses require an additional copay, even if my prescription hasn’t changed?

Contact lenses are considered an elective medical device that requires evaluation of not only the prescription but also the fit–do the lenses fit too loosely vs too tight? Is the material breathable? Are the lenses moving/rotating excessively? Are the lenses overall comfortable? Are the lenses causing any damage/adverse effects to the eyes? The doctors need to evaluate all of this, which requires additional time and resources. For this reason there is an additional contact lens fitting fee required to be fit in/update contact lens prescriptions.

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