Insurance and Fees

We participate with many major insurance plans. A list of insurance plans that L.O. Eye Care participates with is available here. Insurance plans change frequently so please check with your insurance carrier prior to your appointment to ensure your coverage. Our billing staff will be happy to answer any of your insurance questions at 517-337-1668.

Frequently asked billing questions:

Why didn't my insurance pay for my exam?
There are two types of insurance that cover eye care, Vision Insurance and Medical Insurance. L.O. Eye Care must bill the appropriate insurance as legally directed. Although the examination that you receive may be the same or similar to previous visits, the reason for the exam and the doctor's diagnosis dictate how we must bill our patients.
Vision Insurance - (EyeMed and VSP, etc.)
This type of insurance covers routine vision care (i.e. regular eye exams for glasses and contacts) when no medical eye problem or related complaint specifically exists.

Common diagnoses for which Vision Insurance would be billed are:

  • Amblyopia (vision loss with significant uncorrected refractive error)
  • Anisometropia (unequal refractive error)
  • Astigmatism (misshaped curvature of the eye)
  • Emmetropia (normal eyes)
  • Hyperopia (farsighted)
  • Myopia (nearsighted)
  • Presbyopia (bifocals)

Medical Insurance - (Blue Cross/Blue Shield, Medicare, Aetna, etc.)

This type of insurance provides benefits for the treatment of medical problems including medical eye problems. To obtain coverage under medical insurance, a symptom or complaint indicative of eye disease, eye injury, or a chronic medical condition is the reason for your visit.

Common diagnoses for which Medical Insurance would be billed are:

  • Bullous Keratopathy
  • Cataracts
  • Conjunctivitis
  • Corneal Edema
  • Corneal Erosion
  • Corneal Injury
  • Corneal Transplant/rejection
  • Dermatochalasis
  • Diabetes
  • Dry Eyes
  • Ectropion
  • Entropion
  • Eye Pain
  • Floaters
  • Foreign Body
  • Fuchs Dystrophy
  • Glaucoma
  • Headache
  • Herpes Simplex
  • Iritis
  • Keratitis
  • Lupus
  • Nasolacrimal Duct Obstruction
  • Neoplasm Benign or Malignant
  • Ocular Hypertension
  • Pseudostrabismus
  • Pterygium
  • Ptosis
  • Retinopathy of Prematurity
  • Rheumatoid Arthritis
    I came in for my yearly eye exam - shouldn't it be billed to my vision insurance?
    If you have a medical concern such as cataracts, blurry or dry eyes, or any medical diagnosis and medical insurance must be billed.
    Why do I have a $44 charge for a "refraction fee"
    A refraction is a test generally used to determine how well a person sees. Refractions may be necessary for the physician to diagnose your eye condition.

    If you have a medical problem, your visit must be billed to your medical insurance and you may still need a refraction. Unfortunately, refractions are not covered by some insurances, such as Medicare, even if a patient has glaucoma, cataracts, etc.