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As a service to patients, we accept reductions in our usual fees by participating in most area health plans. These include:

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Please consult your plan booklet for what is and is not covered. For Eye Services, many plans distinguish between "vision care" and medical/surgical eye care. Both types of services usually cannot be covered on the same day.

VISION CARE is often a rider to a more comprehensive medical plan. It covers routine, non-emergency visits, when there is no medical or surgical problem; and no complaints or symptoms other than related to vision correction. There may be discounts on glasses or contacts.

Even if you have no vision care plan, the MED/SURG plan will cover eye visits where there is a diagnostic problem or chronic condition that needs monitoring or treatment.

If your company or group does not have a vision care rider, let us know, and perhaps we can customize a plan for your purposes.

Medicare does NOT cover routine visits under any circumstance! It also does not cover the measurement for glasses, called "refraction." Medicare does not cover eyeglasses or contacts, with one exception: Post cataract surgery eyewear is covered ONCE per lifetime.

Medicare also never provides full coverage. They pay 80% of what they allow a participating doctor to charge. They also charge a yearly deductible. These amounts are by law the patient's responsibility unless another (secondary) plan pays them. The doctor may not write them off unless significant hardship exists. It is your responsibility to provide us with the correct and up-to-date information on any secondary insurances you have and to make sure your coverage is current on the date of service.

For us to file your Medicare claim and receive payment, you must sign a form that assigns the benefit to us.

Medicaid covers routine visits and some eyewear as well as Medical care. Medicaid drug coverage is usually more limited than other plans.

Those with no insurance and severe eye disease can sometimes obtain coverage through the New Jersey Commission for the Blind and Visually Handicapped.

When we have a contract with your plan, we bill your insurance for this fee. In some cases, there is a deductible or co-payment, which is DUE AT THE TIME OF SERVICE. Some plans also require referrals from the primary care doctor for a service to be covered. We make every effort to inform both you and the primary care doctor of what the expected services will be ahead of time, so as not to delay your care. It is YOUR responsibility to pick up the referral!

Some plans require that some or all services be preauthorized to be covered. This can sometimes delay care. We will help you navigate these obstacles.

Your HMO or Commercial Plan may not cover all necessary or desired services. You are responsible for services not covered. It is best to understand what your insurance does and doesn't cover. In addition, if your plan has a deductible, services may not be covered or fully covered until the deductible is satisfied.

Some patients have plans that do not require referrals. Some plans have different coverages depending if the doctor is in network. If we are not in network, let us know, and we will try to become part of your network (unless it is not economically feasible for us to do so). For plans that we are not contracted with, you may have out of network coverage. For all non-covered services of any plan, payment is due at the time of service unless other arrangements have been made.

Some out of network plans reimburse the patient for services rendered. The patient is supposed to pay for the service. For your convenience, we will allow you to receive the payment first, and then pay us. Remember that in these cases you still have the payment responsibility!

If there is no coverage for a service or procedure, payment arrangements will be discussed and worked out in advance. This could also include cosmetic and elective procedures, or upgraded cataract implants plus associated refractive services. In some elective procedures, financing can be obtained through third parties. We also accept MasterCard, Visa, and Discover cards.

In some cases, we do not know in advance as to whether Medicare or other insurance will or won't cover a service. If we are unsure, you may be asked to sign an "Advanced beneficiary Notification" form (ABN) indicating that we have so informed you, and that the bill is your responsibility if Medicare denies the coverage.

For contact lenses, full payment is required to order. Fitting is required to establish a contact lens prescription, and fitting fees may apply.

Despite best efforts, questions and problems occasionally do arise about insurance issues. We attempt to verify coverage at the time of your visit before you are seen. You can help by making sure you do not schedule an "insurance-covered" elective appointment AFTER your coverage has expired!

Please do not hesitate to bring any questions or problems to our attention. The health of your eyes is our primary concern!

PLEASE BRING ALL YOUR UP-TO-DATE INSURANCE CARDS WITH YOU AT EACH VISIT!

If you get a new Medicare card with a new number, please inform us and bring it to your next visit.