Managed Care - Frequently Asked Questions
What Does my Insurance Cover?
Ultimately, you, as the patient, are responsible for being informed as to exactly what benefits you are entitled to through your health coverage. Your employer purchases a policy that they negotiated with the insurance carrier and sets the limits of your coverage. Through our experience, we may be able to help answer your questions, but we strongly advise that you check with your insurance company before visiting our facility.
Will I Have To Pay Today?
In most cases, you will be responsible for some payment at the time of service. Most insurance companies require a co-payment.
Why Was My Comprehensive Eye Exam Not Covered By My Medical Insurance?
Some insurance plans do not pay for "routine" care. Health insurance is meant to cover medical care associated with an illness. If the doctor finds a medical diagnosis during your exam, it is likely that your visit will be covered. If you have a refractive condition (i.e., nearsightedness, farsightedness, or need reading glasses), it is considered routine eye care, and not medical.
What Is A Vision Plan?
Some employers purchase a vision "rider" to your health insurance policy that allows routine eye care and often glasses or contact lenses. This is most often offered through another company, such as Davis Vision, VSP, CVC, NVA, or similar programs. If you have coverage for routine eye care through a vision plan, please specify this when making your appointment. This usually requires prior authorization from the vision plan, a voucher or a referral. This may take several days to obtain and cannot always be done on the day of your visit. Call your vision plan for more information.
Do I Need A Referral?
Always check with your insurance company first before making your appointment. To be safe, you should always bring a referral in case the doctor finds a medical diagnosis during your eye exam. If you know that you suffer from an eye condition, you will probably need a referral unless your insurance company does not use them.
What Is A Network Provider or Participating Physician?
Not all doctors are on all plans. When you make your appointment, tell us your insurance plan so we can schedule you to see a participating doctor. Always ask if the doctor participates with your plan or you may have to pay IN FULL for the exam.
How Do I Make an Appointment?
Call:
- (212) 938-4117
- (212) 938-4157
- (212) 938-5851
For comments or questions contact:
uoc@sunyopt.edu | 1-888-277-5666