Insurance

Vision Plans Accepted:  Always Vision, Avesis, Block/Superior Vision, Block Seton CHIPS, Davis Vision, Eye Med, FEP Blue Vision, Health First, Medicare, Medicaid-Traditional, Medicaid -Opticare, Multi-Plan/ PHCS, National Vision Administrators (NVA), Spectera, Safeguard Dental and Vision, Tricare/Humana Military, TML (TX Municipal League), Vision Service Plan (VSP-Affiliated plans only)

Medical Plans Accepted:  Aetna, Blue Cross Blue Shield, Medicare, United Health Care (UHC)

Discount Plans Accepted:  Coast to Coast, Eye Med

Non-Participating Provider:  Out of Network for Cigna, Humana and certain Medicare Advantage plans

Flexible Spending Accounts/HSA and Cafeteria Plans are accepted.

 

Some examples of employer insurance plans we accept are (subject to change):

University of Texas, State and Federal Employees, Austin ISD, Hays ISD, Home Depot,  Cabela’s , Grande Communications,  Military Personnel, US Postal Service, Lowes, Whole Foods,  HEB, Walgreens

 

Capital Eye Care, PC Insurance Policy:  As insurance plans vary greatly we suggest that you contact your insurance provider regarding medical or vision care coverage. We will contact your insurance carrier to obtain pre-authorization prior to your exam. Pre-authorization does not guarantee payment to our office. Any denied claims are the responsibility of the patient. Certain deductible and co insurance amounts apply to the amount of coverage for each individual plan. If you have specific questions about your vision or medical benefits please feel free to call our office or check with your Human Resources dept. In order to verify medical/vision benefits, we will need the insured patient name, subscriber social security number, group or plan policy number, date of birth and a phone number. Please bring your vision and medical insurance cards to your appointment.

Vision insurance plans cover routine exams for glasses and contact lenses and patients are eligible for one exam per year. Routine eye exams performed are devoid of any medical eye health diagnosis or treatment.

Medical eye health diagnosis and treatments are covered benefits through the patient’s medical insurance. Medical insurance plans cover office visits with separate co-pays. Certain medical insurances cover routine well vision visits.  If you have a vision or medical insurance plan that we do not participate in, we will give you an itemized receipt so that you may file your claim with your insurance provider.

As with all medical practices, fees are dependent upon level of service provided at the time of the visit. Prices quoted over the phone are just a baseline set price and may increase if conditions warrant further testing.

Medicare Disclaimer:  We accept what Medicare considers a fair fee for services rendered at our office. Patients must pay an annual deductible toward any qualified health services. Medicare pays 80% of “approved fees” and the patient is responsible for remaining 20% once the deductible is paid. Supplemental insurances will cover the 20% but we must file the claim with them. It is the responsibility of the Medicare insured patient to let us know of any secondary insurance plans. Refraction for glasses/contacts is not a covered benefit unless performed after cataract surgery.