Insurance Coverage
Eye Associates of Lancaster participates in many major health care plans. In such cases, we will submit your charges directly to them. Patients are responsible for their copayments and any non-covered services at the time of their appointment.
Please read your insurance plan carefully, since the amounts paid for office visits and procedures may vary widely from one plan to another. According to our office policy, concerns about any insurance reimbursement should be discussed between you and your insurance company.
To our vision and wellness plan patients: Vision plans cover routine eye exams for naturally occurring problems with your eye such as myopia, presbyopia, or astigmatism for which you would need glasses or contact lenses to correct. Eye Associates participates with Vision Service Plan (VSP) and Vision Benefits of America (VBA).
You may have regular medical insurance benefit that covers an exam and refraction. It is your responsibility to inform our staff at the time of scheduling if your intent is to use this benefit.
Often times you may have diseases of the eye that may require your doctor to code the exam as a medical condition and/or perform further diagnostic testing. Many vision and wellness plans do not recognize these as covered services. You may need to use your medical insurance for these tests.
If Eye Associates does not participate in your vision plan, you will be responsible for the charges and we will give you a receipt in order for you to submit to your vision plan. If you have any questions, please ask a staff member to discuss.
To our Medicare patients: Our office will submit the necessary information to Medicare and we will accept Medicare assignment. Medicare will pay 80% of the approved bill. The remaining 20% and any non-covered services will be the responsibility of you or your private insurance company.
Our office will submit the necessary information for those patients whose secondary coverage includes the services provided. If your plan does not cover office visits, you will need to submit a claim to your plan after prepayment to Eye Associates.
Our billing department is available to assist you with any questions or concerns you may have about costs, including the possibility of payment plans.
Payment for Services
Payment for all services is the responsibility of the patient. Payment for office visits is expected at the time of your visit when service is provided. As a patient, you will be given an itemized receipt that may be attached to any form your insurance company requires. Payments may be made in cash, check, or by Visa, MasterCard, or Discover in our medical offices or optical shops.
Participating Medical Plans
- Advantra PPO (Health Assurance)
- Aetna – PPO – HMO – Medicare Plans
- AmeriHealth Administrators/Blair Mill/Gettysburg Health Plan
- Berkshire Health Plan/PPHN
- Capital Blue Cross
- Capital Blue Cross Keystone Health Plan Central
- Cigna
- Coventry Health Care/First Health
- Devon Health Services
- EHP
- Evercare
- Freedom Blue PPO (Highmark Blue Shield)
- Geisinger Health Plan
- Great West Healthcare
- Health America
- Health Assurance
- Health Net (formerly Tricare)
- Highmark Blue Shield
- Humana PPO
- Humana Vision Care Plan (VCP)
- InterCounty Hosp Plan
- Medicare Complete Choice (United Healthcare)
- Medicare Novitas Solutions
- Medicare Railroad Retiree
- Penn State Health Pass
- Personal Choice (Independent Blue Cross)
- Preferred Health Care/PHC/Unity/PPHN/Old Order Group
- Secure Horizons Direct
- Senior Blue (Capital Blue Cross)
- Teamster’s Central Pennsylvania
- Today’s Options PPO
- Unison Advantage of Pa (Medicare Only) HMO requires referral from PCP
- United Healthcare (Not Community Plan)
- UPMC for Life- Medicare
- VIBRA Health Plan
Participating Vision Plans
- VBA – Vision Benefits of America
- VSP – Vision Service Plan
Participation with insurance plans may change at any time. Please consult with your benefits manager to confirm that Eye Associates of Lancaster is available as a provider.
To Medical Assistance (Medicaid) patients: Eye Associates does not participate in any medical assistance plans including Healthy PA, Highmark Wholecare, Amerihealth Caritas, United Healthcare Dual Complete and UPC for You.
Care Credit
Care Credit is a flexible monthly payment option. It is specifically designed for eye surgery, vision and LASIK with interest free financing and low monthly payments.
For more information:
Visit www.carecredit.com or call (800) 677-0718 to apply for a CareCredit card.
Good Faith Estimate Disclaimer
Good Faith Estimates show the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on the Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises