top of page

INSURANCE 101

Insurance plans are often the most confusing and frustrating part of the eye exam process.  Albertville Eye Care's staff is trained to work with direct bill, in network, and out-of-network insurance plans. We can explain your benefits and submit forms for reimbursement, but we cannot provide specific policy information.

What Albertville Eye Care needs from you before your initial visit:

  • Contact your Human Relations department or the benefits package you received from your employer to obtain the specifics on your insurance plan.

  • Be sure to get the name of the insurance carrier for your Medical Insurance Plan and the Routine Vision Plan. In many cases, these are different, similar to dental insurance.

  • If you are not the policyholder be sure to give us the:

  •     Policyholder's legal name

  •     Policyholder's ID number

  •     Policyholder's date of birth

  •     Policyholder's social security number

  •     Relationship to policyholder (spouse, domestic partner, child, etc.)

 

  • Contact us with your complete insurance information as soon as possible, but at least 24 hours before your appointment. This allows us enough time to verify your benefits and gives us time to notify you of any issues and solve them before your visit.

PATIENT INFORMATION

Vision Insurance vs. Discount Plans

It is helpful to ask your Human Relations department if your vision benefits are an actual insurance benefit or simply a discount plan. We honor both, but the coverage for an actual insurance plan is much higher than the discount only plans.

Out-of-Network Benefits

If Albertville Eye Care is not listed as a provider for your medical or vision plan you may have out-of-network benefits. We are more than willing to submit a claim on your behalf or help you submit a claim yourself. However, payment for services and products will be required at the time of service or paid in full before product is released.

Patient Responsibility

The patient is ultimately responsible for the cost of services provided and materials ordered. If your insurance company fails to acknowledge claims submitted, we will do all we can to help you. However, if we cannot resolve the issue after 30 days, you will be held responsible for these charges.

Coverage for Glasses vs. Contacts

Almost all Vision Insurance plans allow either glasses or contacts. The benefit is usually larger on glasses because you get the savings on both the frame and lenses, whereas if you use the benefit for contacts, you are only getting the lens benefit.

On top of that, if you use your benefits for contacts, it pushes back your entire material benefits for whatever period your company specifies. In other words, if you company only allows you to get frames every two years, using your benefits towards contacts still pushes back your frame benefit for the full two years. They will not cover anything toward the patient's frame during that time.

bottom of page