Pediatric & Special Needs Optical

At Children’s Eye Care, we participate with a large variety of medical insurance plans. However, Children’s Eye Care does not participate with any vision insurance plans.

Explore the Distinction between Medical and Vision Insurance for Your Eye Exam

Navigating the complexities of billing in an eye doctor’s office, particularly determining whether to bill the medical or vision plan, poses significant challenges. It’s crucial to be informed about the process and intricacies involved in billing for these visits.

To begin, it’s essential to understand that an ophthalmologist is a medical doctor, akin to a cardiologist, providing comprehensive medical eye exams and conducting surgeries. In our practice, none of our ophthalmologists participate in vision plans. This strategic decision stems from the unique sub-specialty training our doctors undergo, enabling them to offer specialized care for children with specific eye conditions and address complex strabismus in adults—an expertise that few other doctors in the state possess.

The shortage of pediatric ophthalmologists exacerbates the issue, resulting in extended wait times for patients seeking specialized care and surgery. If our pediatric ophthalmologists were to engage with vision plans, there’s a risk of their schedules becoming inundated with routine care, which does not necessitate a pediatric fellowship. This could further limit the availability of providers capable of delivering the specialized care required by patients with specific training needs.

Therefore, it’s crucial to note that when patients see one of our ophthalmologists, billing will not involve a vision plan or a vision rider. This ensures that the unique care and expertise provided by our doctors remain focused on those who truly need their specialized training, avoiding potential limitations in the availability of such care.

Accepted Vision Insurances

• None

Accepted Medical Insurances

Please be aware that the list provided is for reference purposes only. Our practice can verify participating plans for your convenience. It’s important to note that not all of our doctors participate in every plan mentioned above. While we will make every effort to schedule you with a participating doctor, we cannot guarantee exclusive access in the event of an emergent visit for a vision-threatening issue.

If your insurance carrier is not included in this list, we recommend contacting your carrier directly to verify your benefits and explore their referral network. Our commitment is to assist you in navigating your insurance coverage, ensuring you receive optimal care.

AARP
Aetna – PPO, POS and HMO
Aetna Better Health of Michigan
Ambetter
Beaumont Employee Health Plan (BEHP)
Blue Care Network HMO
Blue Care Network HMO Medicare Advantage
Blue Cross Blue Shield (BCBS)
Blue Cross Blue Shield PPO Medicare Advantage
Blue Cross Blue Shield Complete
Blue Cross Blue Shield Physician Choice
Blue Cross Blue Shield Complete
Blue Cross Blue Shield Federal Employee Plan
Children’s Special Health Services (CSHCS)
Christian Care Ministry (MedShare)
Cigna – PPO, POS and HMO
Cofinity (previously known as PPOM)
Community Care Associates
Coventry Care Commercial PPO
Coventry Care Medicare Advantage HMO
First Health
Golden Rule Commercial Plans
Great West Health Plan Commercial Plans
HAP HMO (except Henry Ford and Geneysis networks)
HAP HMO Senior Plus (except Henry Ford and Geneysis networks)
Health Alliance Plan PPO
HAP Medicare Advantage
Humana PPO, HMO, X and Advantage POS
Ingham County Health Plan
Keenan Health
McLaren Health Plan Commercial and Medicaid
McLaren Health Plan Medicare Advantage
Medicaid
Medicare
Molina and Molina Marketplace
Molina Medicare Advantage
PHCS/Multiplan
Physician’s Health Plan Mid-Michigan Commercial and Medicaid
Priority Health HMO Commercial and Medicaid
Priority Health HMO Medicare Advantage
Railroad Medicare
Sparrow Health PPO & HMO
St John Smart Plan aka Ascension Health Plan
Teamsters
Total Health Care Commercial and Medicaid
Total Health Care Medicare Advantage
Tricare Prime and Standard, Tricare for Life, VA Community Care, CHAMPS VA
United Health Care Commercial PPO, HMO, POS, Navigate Medicare Advantage
United Health Care Community Plan (UHCCP)
UMR
Wellcare Medicare Advantage with Meridian