Insurance

 

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Insurance Plans may vary by location and are subject to change.  Please call to verify.

 

Insurance List for Arizona

Advantica

Aetna

AHCCCS

Always Care Benefits/First Look

Avesis

AZFMC

AZ Priority Care

BCBS of AZ

Block Vision

Bridgeway Solutions

Care 1st Health Plan

 

 

Cenpatico

Cigna Health Plan

CMDP

Corizon

Correct Care Solutions

Coventry

Davis Vision

Envolve Vision

Eye Specialists of Arizona Network

Galaxy

Health Choice

 

 

Health Net

Health Smart

Humana

Humana Vision Care Plan

IECN

Inmate Health Services

MES Vision

Medicare

Medicare Rail Road

Mercy Care Plan

Mercy Maricopa Integrated Care

 

 

Multi Plan/PHCS/Moda Health

National Preferred Provider Network/Stratose/Zelis

National Vision Administrators (NVA)

Phoenix Health Plan

Sight Care

Spectera

Three Rivers

 Tricare

 

 TriWest/VA

United Health Care

United Health Care Community Plan

University of Arizona Health Plans

Vision Care Advantage

VSP

Insurance List for New Mexico

Always Care Benefits/First Look Vision

AmeriGroup

Avesis

BCBS of NM

Block Vision

Cigna Health Plan

Coventry Health Plan

 

Eye Med Vision Care

Health Smart

Humana

Humana Vision Care

March Vision

Medicaid

Medical Eye Service Vision

 

Medicare

Medicare Rail Road

Molina Health Plan

Multiplan/PHCS/ Moda Health

National Vision Administrators (NVA)

Presbyterian Health Plan

 

Prime Health Plan

Sight Care

Spectera

Three Rivers

Tricare

United Health Care

Vision Care Advantage

VSP

Insurance FAQ

What Makes Vision and Medical Insurance Different?

Medical insurance can be used for medically related vision needs like surgery, emergency care and treatments for eye conditions like glaucoma or infections. Vision Insurance is better described as a benefit that offsets the cost of vision needs like wellness exams, refractions, and can include allowances for lenses and contacts. 

When Can I Use My Vision Insurance?

Vision Insurance can be used for routine eye exams that allow you to get your refraction and a new prescription, however, you will not be covered for any medical diagnoses or a more comprehensive eye exam that would screen you for the development of eye conditions like cataracts and glaucoma. 

How Often Can I Use Vision Benefits?

Vision Benefits typically can only be used once a year or once every other year, depending on the plan. Because of this, if you want to use your benefits for a refraction and lens or contact benefits, you will need to do both during the same appointment in order to avoid being billed separately for both.

Why do I have to Pay for a Prescription When I have Vision Insurance?

If you come in for a Comprehensive Eye Exam, meaning you are screened for eye conditions and are given a more all-encompassing exam, your medical insurance will be used to cover it and not your vision insurance. You would use Vision Insurance for your prescription and glasses or contacts benefits. However, your vision insurance cannot be used at the same appointment as you use your medical insurance because legally, two insurances cannot be billed for the same encounter. This means if you want to get both your comprehensive exam and an updated prescription, you will need to either pay separately for the prescription or come in for a routine exam and refraction on another day to use your vision benefits and receive your prescription.

Can Insurance be Used to Cover LASIK?

Typically, not. LASIK is almost always considered an elective procedure and would therefore not be covered by insurance. However, some businesses do offer programs to help their employees pay for LASIK. At Southwestern Eye Center, we also offer CareCredit as a financing option to be able to make affordable payments over time.

Can Insurance be Used for Eyelid Surgery?

Upper Eyelid surgery can be deemed medically necessary based on precise measurements. If the sag of your eyelid is inhibiting your vision, you may be eligible for coverage. If you opt to do more cosmetic fixes along-side the medical surgery, those will not be covered. 

How Do I know if I'm in Network?

The best way to find out if you are in-network for your appointment is to call to verify for the most accurate and up-to-date information.