Insurance

 

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

Medical Insurance 

AARP Medicare Advantage

AARP Medicare Advantage – Banner Health Network

AARP Medicare Advantage – Optum Network

AARP Medicare Advantage – Tuscon / Rural / Direct Networks

Advantage Health Plan

Advantra Freedom Medicare Advantage PFFS Plan

Air Gas Safety (Optical)

Aetna Commercial and Medicare Advantage

AHCCCS (State Medicaid)

Arizona Care Network

Arizona Complete Health (formerly Healthnet AHCCCS)

AZPC Network

AZ Foundation for Medical Care

Arizona State Physicians Association (PHCS, MultiPlan, Beech Street, Three Rivers, USA Managed Care, Galaxy Health)

Banner Health Network

Banner Choice Plan

Banner University Family Care AHCCCS

Beech Street PPO

Benesight

Blue Cross Blue Shield of AZ

BC BS Blue Alliance (BHN)

BCBS Medicare Advantage

BCBS Medicare Advantage – Banner Health Network

BCBS Medicare Advantage – JCL / MIHS Networks

BCBS Medicare Adv

BC BS of AZ EyeWear (Optometrists)

Bridgeway Health Solutions

Bright Health

Care 1st AHCCCS and Medicare Advantage

CareMore Medicare Advantage

Cigna – Commercial and Medicare Advantage

Champva

Eastern AZ College Advisory Team

CoreCivic

Coventry National Networks (First Health, Mailhandlers)

Galaxy Health Networks (ASPA)

Gila River Healthcare

Health Choice Arizona (Medicaid)

Health Choice Generations Medicare Advantage

Health Net of Arizona – Medicaid and Medicare Advantage

Healthstar

HMA (AZ Medical & Rural Networks)

Humana – Commercial and Medicare Advantage

Indian Health Services – Statewide

Intel Connected Care

John Deer Health Insurance

Lions Noon and Sunrise Volunteer Program (Flagstaff)

Lions Club (Tucson)

Logistics Heath LHI Army Reserves

Magellan Complete Care AHCCCS

Medicare Part B

Mercy Care AHCCCS

Mercy Maricopa Integrated AHCCCS

Mercy Care Advantage

NACA (Native Americans for Community Action) Flagstaff only

National Preferred Provider Network

QTC Medical (Federal Occupational Health Contract includes National Guard)

United Health Care of AZ & Affiliates

United Community Health Plan (formerly APIPA)

United Health Care (UHC) – Community Plan (AHCCCS)

United Health Care (UHC) Medicare Advantage

United Healthcare Compass

UMR

UHC Tricare

University Care Medicare Advantage (Banner University)

TriWest Healthcare Alliance

CRS (Children Rehab Services)

 

University of Arizona Health Plans

Multi Plan

PHCS (Private Healthcare Systems)

Premier Vision (Medical Plan is Well Care)

Railroad Medicare

Refuge Medical Assistance Program

RSA Contract (AZ Department of Economic Security, Rehabilitation Services)

Rural Arizona Network

Scan Desert Health (MedAdv)

Scan Embrace Plan (ISNP)

SightCare (CRS)

Southwest Administrators

Spectera

StarMark

TriWest

Uniform Medical Plan

Union Benefits of America Vision Plan

VA Community Care Network (formerly VAPC3)

Three Rivers (ASPA Network)

Vision Insurance

Always Vision

Avesis

AZ Optometric Association Vision Program

Davis Vision

ECCA Managed Vision Care

Eye Benefits

EyeMed
Members whose medical insurance is Cigna Commercial or Cigna Medicare Advantage

Humana Vision Care Plan Formerly Comp Benefits

March Vision

Nationwide Vision (Sightcare)

Opticare

Superior Vision Services

 

Vision Care Direct

Vision Benefits of America

Vision USA Volunteer Program

VSP (Vision Service Plan)

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.