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Major Medical Insurance and Vision Plans

Understanding eye care insurance and vision plans can be complicated—we are here to help you make the most out of your benefits!

Helping you maximize your eye care benefits

We are in-network with many major medical insurance and vision plans.

We encourage all patients to contact their insurance company directly to verify coverage, eligibility and any out of pocket costs prior to their appointment. Coverage can vary based on your plan, the services you need and if you’re under 18 years old.

Major Medical Insurance

Vision Plans

If you don’t see your plan listed call the phone number on the back of your insurance card.
Here are the questions to ask:

  • What is my preventative eye care coverage?
  • When does that plan renew (every calendar year or from the last date of service?)
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Medical Insurance Coverage

We accept most major medical insurance plans for medically necessary eye care services. Medical insurance covers the treatment of eye diseases, conditions, and injuries.

When Medical Insurance Applies

Eye Diseases and Conditions:

  • Dry eye syndrome diagnosis and treatment
  • Glaucoma evaluation and management
  • Diabetic eye examinations
  • Macular degeneration monitoring
  • Cataracts and other eye conditions

Eye Injuries and Emergencies:

  • Foreign objects in the eye
  • Chemical exposure or burns
  • Eye trauma or injury
  • Sudden vision changes
  • Eye infections and inflammations

Chronic Condition Monitoring:

  • Follow-up care for ongoing eye conditions
  • Post-surgical eye care
  • Management of eye-related complications
  • Treatment monitoring and adjustments

Out-of-Network Coverage

Some insurance plans provide out-of-network benefits, allowing you to receive care from your preferred provider while still receiving partial coverage.

How Out-of-Network Benefits Work

Reimbursement Process:

  • You pay for services at the time of your visit
  • We provide detailed receipts with proper coding
  • You submit claims directly to your insurance company
  • Insurance reimburses you based on your plan benefits

Typical Coverage Levels:

  • Eye examinations: Often 50-80% of usual and customary fees
  • Materials: May include partial reimbursement for eyewear
  • Specialty services: Coverage varies by plan and procedure
  • Annual maximums: Different limits may apply

Our Support:

  • We’ll provide all necessary documentation for claims
  • Our staff can help explain your out-of-network benefits
  • We offer guidance on maximizing your reimbursement
  • Payment plans are available to help manage upfront costs

Flexible Payment Solutions

Insurance and Direct Payment

Insurance Processing:

  • We file claims directly with most insurance plans
  • Electronic claims submission for faster processing
  • Explanation of benefits provided for all services
  • Balance billing only after insurance processing

Payment Methods:

  • Cash and personal checks accepted
  • All major credit cards (Visa, MasterCard, American Express, Discover)
  • Debit cards with PIN or signature
  • Electronic payment options are available

Healthcare Financing

CareCredit Healthcare Financing:

  • No-interest payment plans available
  • Extended payment terms for larger expenses
  • Quick application process with immediate decisions
  • Special financing promotions are often available

Health Savings Accounts (HSA):

  • Use pre-tax dollars for eligible eye care expenses
  • Covers routine exams, treatments, and eyewear
  • Maximum tax savings for healthcare costs
  • Easy payment processing for HSA cards

Flexible Spending Accounts (FSA):

  • Apply FSA funds to eligible vision expenses
  • Use-it-or-lose-it funds make timing important
  • Covers most eye care services and materials
  • Direct payment from FSA cards is accepted

Our Insurance Verification Service

Before Your Appointment

Benefit Verification:

  • Our team verifies your coverage before your visit
  • We explain what services are covered under your plan
  • You’ll know your copayment and deductible amounts
  • Any prior authorizations are obtained in advance

Cost Estimates:

  • Transparent pricing for all recommended services
  • Clear explanation of insurance coverage
  • Estimate of your out-of-pocket costs
  • No surprise bills or hidden fees

Pre-Authorization:

  • We handle prior authorization requirements
  • Specialist referrals processed efficiently
  • Medical necessity documentation provided
  • Insurance approval obtained before treatment

Day of Service

Smooth Processing:

  • Insurance cards verified and copied
  • Copayments collected at check-in
  • Claims submitted electronically same day
  • Explanation of benefits provided

Clear Communication:

  • Your benefits explained in simple terms
  • Coverage limitations discussed upfront
  • Treatment options within your budget
  • Payment arrangements available if needed

FAQ

What's the difference between Vision Plans and Medical Insurance for eye care?

There are many things that can happen with your eyes that are considered a medical diagnosis, in which case your major medical insurance will be billed for the visit. However, most major medical insurance does not contribute towards material benefits (for example, glasses or contact lenses). Vision Plans are essentially like a discount plan for material benefits. Each plan differs in coverage based on what your employer negotiated in their contract.

Can I use both vision plans and medical insurance?

In some cases, yes. We’ll explain how this works for your specific situation.

What if I don't have a vision plan or major medical insurance?

We offer transparent pricing for all services and accept various payment methods, including cash, credit cards, CareCredit financing, and HSA/FSA funds. Many medical insurance plans also cover certain eye care services.

Do you offer payment plans?

Yes, we work with CareCredit for 0% financing for patients over 6 or 12 months.

How much will my visit cost?

Costs vary based on your insurance coverage and the services you need. Our team will verify your benefits and provide cost estimates before your appointment so you know what to expect. We believe in transparent pricing with no surprises.

What forms do I need to complete?

Paperwork is annoying. So we’ve eliminated as much of it as we can! We’ll ask you questions in the exam room and enter the information while you’re here. No extra forms ahead of time.

Do I need to have my records sent from another eye clinic before you can see me?

The short answer is no, we don’t need them ahead of time. We start from scratch often with new patients, so that’s not a problem at all.

What should I do if I have an eye emergency?

If it’s during our normal business hours, call the clinic, 952-898-4088, and we’ll work you into the schedule to get you back on track. If it’s after normal business hours, follow the prompts on the message for the clinic, and Dr. Rudser will call you back.

Enjoy Clear Vision with Advanced Eye Care

Are you ready to up-level your eye care experience? Reach out to Advanced Eye Care Professionals for more information about our services. We’re happy to help!

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Advanced Eye Care Professionals provides complete eye care and a wide selection of lenses and frames to Lakeville and nearby communities. Call or click to get the quality care you deserve.

Contact Us

(952)-898-4088
Fax: (952)-898-0883

Email Us

17799 Kenwood Trail
Lakeville, MN 55044

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