Medicare
Hedgeye Optometrist, P.C. is a contracted Medicare provider for traditional Medicare plans.
Traditional Medicare
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If the exam is medical, Medicare will help cover some of the costs. Refraction services are NOT covered by Medicare, and will be expected to be paid on the date of service. Depending on your deductible and if you have secondary coverage, you may receive a statement after your claim has been processed by your insurance.
Medicare Advantage Plans
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We are an OUT of network provider for Medicare Advantage plans. If you have a PPO plan, we can still file it for you under your out of network coverage. Typically, you will have higher copays or coinsurance depending on the type of replacement plan you have.
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Some MA plans have routine vision coverage. However, depending on the reason for your vision changes and the type of services you wish to receive, these will not be covered under a routine vision plan, and should be billed through your medical plan.
Refraction services are not typically covered by Medicare plans. You will most likely be responsible for your copay AND refraction charges on the day of your exam.
Eye Health and Aging
As we get older, our ocular health changes. We develop cataracts and are at a higher risk of developing some type of ocular disease (macular degeneration, retina conditions, etc.)., and therefore a routine exam to strictly look at basic eye health and refraction changes is not always enough. When calling to schedule an appointment, please make sure you let our staff know what type of concerns and visual symptoms you have so we can let you know if you Medicare plan can be used to help cover the costs of your exam.