Optometry Vision Therapy Center
Eye Associates

Insurance & Vision Plans

Helping You Understand and Maximize Your Benefits

Our Commitment to You

Navigating insurance can be complex, and our team is dedicated to helping you get the most value from your benefits. We will work with you to clarify your coverage and answer any questions you may have.

To start, it's helpful to know that eyecare is covered by two general types of insurance: routine Vision Care Plans and Medical Insurance.

Understanding Your Coverage: Vision vs. Medical

Vision Care Plans

For Routine & Preventative Eye Health

Use For: Vision plans are a wellness benefit designed for routine eyecare, prescription eyewear, and other vision-related services at a reduced cost.

Typically Covers:

  • ✓ Annual comprehensive eye exams
  • ✓ Vision-related conditions like nearsightedness, farsightedness, and astigmatism
  • ✓ Benefits or allowances for eyeglasses and contact lenses

Note: You do not need a medical diagnosis to use this type of coverage.

Medical Insurance

For Medical Conditions & Eye Health Problems

Use For: Your regular health insurance protects you against financial losses due to unexpected eye injuries or disease.

Typically Covers:

  • ✓ Diagnosis and treatment of eye diseases like glaucoma, cataracts, and diabetic retinopathy
  • ✓ Medically necessary exams for symptoms such as headaches, floaters, and light sensitivity
  • ✓ Office visits for acute conditions like pink eye (conjunctivitis), eye injuries, or infections

Note: Coverage is subject to your plan's deductibles, co-payments, and referral requirements.

Our Participating Plans

We accept many insurance plans. If you do not see your plan listed here, please call our office and we would be happy to assist you.

Vision Plans We Participate In:

EyeMed
VSP

Medical Insurance Providers

Medicare
Horizon
Blue Cross Blue Shield of NJ
Aetna
Anthem
Cigna
Health Net
Multiplan
Oxford
PHCS
United Healthcare
VSP

Your Pre-Visit Insurance Checklist

To ensure a smooth visit and clarify your coverage, we recommend reviewing these questions before your appointment.

  • What is the primary reason for your visit?
    Is it a routine vision check for glasses or contacts (likely covered by a Vision Plan)? Or is it for a medical eye condition or symptom (likely covered by Medical Insurance)?
  • Do we participate in your specific plan?
    If we participate, we will submit all forms and receive payment directly from the insurance company. If we do not, we will provide you with the necessary paperwork for you to apply for direct reimbursement.
  • Do you need pre-authorization or a referral from your Primary Care Physician (PCP)?
  • Are you currently eligible for benefits?
    Some vision plans have frequency limits, such as one exam every 12 or 24 months.
  • Do you know your plan's deductibles and co-payment amounts?

For Local Businesses: Custom Eyecare Plans

We partner with local companies to offer privately administered eyecare plans for their employees. We can customize each plan to meet the specific needs of your company, providing your team with access to our services and materials at a reduced cost.

If your company would like to learn more, we would be happy to provide an information packet. Please call our business office at (973) 726-0669 for more information.

We're Here to Help

Our staff is always available to answer any questions regarding your benefits. Please feel free to give our office a call for assistance.

Questions About Your Coverage?

Our knowledgeable staff is ready to help you understand your benefits and make the most of your insurance coverage.

Contact Our Office