Getting Reimbursed for Eye Care in Pennsylvania
Clear, Flexible Ways to Use Your Vision Insurance
Many plans include out-of-network benefits, which means you can receive eye care at Optometric Associates and get reimbursed directly.
We’ve built a simple process to help you use your benefits for eye care services without unnecessary paperwork.
How Vision Insurance Reimbursement Works at Optometric Associates
We partner with Anagram to simplify how you use your out-of-network vision insurance benefits.
Here’s how it works:
- You receive eye care or eyewear as usual.
Your eye exam, eyeglasses, prescription sunglasses, or contact lenses are handled just like any other visit.
- You pay at the time of your visit or purchase.
This gives you the freedom to choose what works best for your eyes, without being limited by the network.
- We handle the claim for you.
Through Anagram, we submit your claim on your behalf. No forms or follow-up are required from you.
- Your insurance reimburses you directly.
If your plan includes out-of-network benefits, your insurance company will reimburse you based on your coverage.
Reimbursement amounts and timing vary by plan. Many patients receive payment within a few weeks.
What Your Vision Insurance May Cover
Many vision insurance plans, including Vision Service Plan (VSP), offer reimbursement for:
- Eye exams
- Eyeglasses
- Prescription sunglasses
- Contact lenses
Coverage depends on your specific plan. If you’re unsure what your benefits include, we can review them with you before your visit.
When Medical Insurance Applies to Eye Care
Not all eye care visits are considered routine. Some visits are billed to medical insurance rather than vision insurance.
Medical insurance typically applies when your visit involves:
- Eye infections or injuries
- Dry eye symptoms
- Monitoring conditions such as glaucoma, macular degeneration, or diabetic eye disease
- Sudden changes in vision
If your visit involves a medical concern, we will explain how it is billed before any additional testing or treatment. In some cases, both medical and vision insurance may apply.
Medical Plans We Work With
For medical eye care, Optometric Associates is in-network with many major plans, including:
- Medicare
- United Healthcare
- Aetna
- Cigna
- Humana
- Aetna Medicare
- AARP Medicare Complete
- Meritain Health
- Coventry Health Care
- United Healthcare Medicare Solutions
- Secure Horizons
- Highmark
- CoreSource
- Geisinger
- Magnacare
- Today’s Options
If your plan is not listed, we can still help you understand your options.
Let’s Help You Understand Your Benefits
Insurance can be confusing, especially when vision and medical coverage overlap.
Our team can:
- Review your benefits with you
- Explain what may be covered
- Clarify potential out-of-pocket costs
- Submit claims when applicable
If you have questions, give us a call or request an appointment online.