Vision plans typically offer a routine eye exam once every 12 months or once every 24 months. These plans usually also offer a benefit or discount for eyewear and/or contact lenses. Our staff will be happy to review or explain any of these benefits to you.
If your eye exam is not routine (i.e. there is a medical exam), then your benefits claim will need to go through your medical insurance. In this case, you are responsible for any copayments, deductibles or co-insurance amounts assessed by your medical insurance.
The Family Eye Care Center & Optical Gallery is contracted with most major health plans. Within some of these health plans, there are certain plans that we are not contracted with. Please call our Billing Department to verify that we accept your specific plan or if you do not see your plan listed below. Our staff is happy to assist you in answering questions about your insurance; however we cannot guarantee payment from your insurance plan.
List of health insurances accepted:
- Blue Cross Blue Shield
- Fallon (We do not accept Fallon Senior or Fallon Mass Health)
- First Health
- Fiserv Health
- Group Insurance Service Center
- Harvard Pilgrim
- Health Net Federal Services
- Health Plans, Inc.
- Mail Handlers
- Medicaid (Mass Health)
- Neighborhood Health
- Network Health
- Oxford Health
- Private Healthcare Systems
- Tufts Health Plan
- Tufts Medicare Preferred
- United Healthcare (We do not accept United Vision/Spectera/Optum Health)
- United Healthcare – Secure Horizons
- US Family Health Plan
The Family Eye Care Center & Optical Gallery is contracted with most major health plans and will bill your insurance company for services rendered as a courtesy to our patients. In order to bill your insurance properly, please bring the following to your appointment:
- Your insurance card
- Payment for your copayment and any non-covered services, i.e. contact lens evaluation, contact lenses, etc.
- A referral if your insurance plan requires one
Please remember that it is the patient’s responsibility to know their insurance plan, to understand what services are covered and not covered and to know if you have deductibles or co-insurance. Please call the member services number for your insurance plan if you have specific questions about your plan benefits.
Deductibles & Co-insurances
Please know that the goal of the Family Eye Care Center & Optical Gallery is to deliver the best and most prudent eye care. If testing and/or procedures are recommended, it has been determined by your doctor that they are a necessary part of your eye care. These services will be submitted to your medical insurance. These services may be applied towards your deductible or coinsurance.
Your insurance plan may require a referral from your primary care physician. If so, please contact your primary care physician to request a referral prior to your appointment. If a referral has not been received by the date of service, the Family Eye Care Center & Optical Gallery reserves the right to reschedule your visit. If a referral is not obtained within the required time frame by your insurance, you may be responsible for the balance.
Routine Eye Exams
Routine eye exam benefits vary by insurance plan. Some plans cover an eye exam every year, others cover an eye exam every two years and some do not cover routine eye exams at all. Please check your benefits before your visit so that you will understand your coverage. If your eye exam is not routine (i.e. there is a medical diagnosis), then your medical insurance will be billed. You will be responsible for any co payments, deductibles or co-insurance amounts assessed by your insurance.
The Family Eye Care Center & Optical Gallery is committed to offering you the best eye care and service. To assist us in this goal please review our billing policies. If you have any questions about your insurance, referrals, or routine eye benefit, our Billing Department will be happy to assist you. This department can be reached Monday through Friday from 8am to 5pm at 978-692-1400, Ext 797.
Forms of Payment
The patient is responsible for their insurance copay and for “non-covered” services and materials at the time of service. Payment may be made by cash, check, money order, or credit card. We accept both Visa and MasterCard. A $30.00 fee will be charged for any checks that are returned by the bank for non-payment. If financially necessary, payment plan arrangements can be made with the Family Eye Care Center & Optical Gallery’s billing department.
Copayments are a contractual obligation between you and your insurance company. All insurances require that co payments be paid at the time of service. If your copayment is not paid at the time of service, there will be a $10.00 surcharge added to the balance.
Occasionally, patients do not have insurance coverage at the time of their visit. The Family Eye Care Center & Optical Gallery offers self pay rates for this circumstance. The rates are based on the services performed and must be paid in full at the time of service.
Cancellation/No Show Policy
Our providers and staff designate a specific amount of time for each patient’s appointment. If you need to cancel or reschedule an appointment, please call our office at least 24 hours in advance. There is a $50.00 fee for missed appointments and appointments cancelled without 24 hours notice.