Insurance

INSURANCE CO
(For medical exams only)
REFERRAL NEEDED? REFRACTION COVERED? ROUTINE EXAM
AARP Not needed Not covered Not covered
UNITED HEALTHCARE AARP MEDICARE COMPLETE-WE DO NOT PARTICIPATE!!! N/A N/A N/A
AETNA MC (HMO)-WE DO NOT PARTICIPATE!! N/A N/A N/A
AETNA MEDICARE Not needed Not covered Not covered
AETNA PPO Not needed SOME PLANS SOME PLANS-EVERY 24 MONTHS
ALLIANCE PPO Not needed MOST PLANS Not covered
ANTHEM BCGOV Not needed Not covered Not covered
ANTHEM HEALTHKEEPERS YES – NO WAIVERS YES Not covered
ANTHEM HEALTHKEEPERS OPEN ACCESS Not needed YES Not covered
ANTHEM HEALTHKEEPERS PLUS Not needed YES Not covered
ANTHEM PPO, & COMPREHENSIVE PLANS Not needed SOME PLANS Not covered
CHAMPUS ACTIVE DUTY Not needed YES YES
CHAMPUS RETIRED Not needed YES, W/ MED DX Not covered
CIGNA HMO YES Not covered Not covered
CIGNA PPO Not needed Not covered SOME PLANS
HUMANA GOLD PPO Not needed Not covered Not covered
HUMANA HMO YES – NO WAIVERS! Not covered Not covered
MAILHANDLERS/COVENTRY Not needed Not covered Not covered
MEDICARE Not needed Not covered Not covered
OPTIMA FAMILY CARE Not needed YES Not covered
OPTIMA HMO Not needed YES Not covered
OPTIMA POS Not needed– must sign waiver for higher out of pocket YES Not covered
SECURE HORIZONS Not needed Not covered Not covered
TRICARE FOR LIFE Not needed DISCOUNTED Not covered
TRICARE PRIME (DR. KURZ AND DR. TOMKO ONLY) YES
*NO REF NEEDED FOR ROUTINE EXAMS FOR FAMILY MEMBERS
YES 1 PER CALENDAR YEAR, NO COPAY.
FOR RETIREES, 1 EXAM/24 MONTHS
(Active duty member must have referral for routine exam, but not the family members)
UNITED HEALTHCARE Not needed SOME PLANS Not covered
VA MEDICAID (not VA Premier or Chartered Health Plan) Not needed YES EVERY 24 MONTHS-FOR 18 YRS & UNDER ONLY!!
VHN/PHCS Not needed Not covered Not covered

 

 

Examples of reasons for a medical eye exam:
Dryness, excessive tearing, injury, diabetes, glaucoma, cataracts, flashes of light, floaters, sudden changes in vision, etc.

 

THE ONLY ROUTINE VISION PLANS WE ACCEPT ARE VSP AND MET LIFE.
MEDICARE REPLACEMENT PLANS FOLLOW THE SAME GUIDELINES AS MEDICARE