Insurance & Payment Information

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Capital Vision Center accepts both Medical insurance and Vision benefit plans

To see if we work with your specific insurance carrier or vision care plan, please call our office for assistance. Our friendly and informed staff will be happy to answer any questions you may have.

* Some insurance plans have a separate vision benefit rider. We may take the medical insurance but sometimes we don’t participate with the vision rider. Please call your insurance/vision carrier before your appointment to make sure we are a participating provider, and to check your eligibility for your benefits. If you are still unsure please call our office and we will gladly help you sort it out. (603) 226-0855

We are also providers for Veterans! If you usually get your care from a VA Medical Center and would rather stay closer to home, contact the “office of community care” at your local VA and request a visit with us through COMMUNITY CARE. You can also give us a call and we can assist any questions you may have.

No insurance? We offer comprehensive eye exams and medical eyecare for patients WITH AND WITHOUT insurance coverage. Our expert employees are also able to assist with “out of network” self submissions for patients with certain insurances plans like Davis Vision, Superior Vision, Spectera, UnitedHealthcare Vision, OptumHealth Vision, or FEDVIP Vision to help patients save on exams/glasses/contacts. Simply submit your receipts to the plan with the out of network form and receive reimbursement from your plan.

 

About Your Insurance/Vision Benefit Plans

• There are two types of plans that will help pay for your eye care services and optical products. You may have both types and Capital Vision Center accepts most plans in both categories: 1. Vision benefit plans (such as VSP and others) and 2. Medical insurance (such as Medicare, Anthem Blue Cross/Blue Shield, and others)

• Some medical insurance plans do have vision benefits for exam services and materials. We will utilize the most appropriate plan for the service, test, or material purchase.

• Please provide your insurance information to our staff at every visit. We need to have your medical insurance cards, supplemental plans, and/or vision benefit plans on file before a service is rendered or material is purchased. We can not retroactively add it after a service is rendered or material is purchased. If a medical insurance or vision benefit plan is presented after, receipts must be self submitted to the plan by the patient for reimbursement.

• We may or may not be in network for all of your benefits you have. If we do not accept your insurance or vision benefit plan, you will be required to pay all non covered fees at time of service and you can self submit receipts to your out of network plan for direct reimbursement.

• If you have both medical insurance and vision benefit plans, it may be necessary for us to bill some services to one plan and some services to the other. Some plans will actually work together to pay for a service. We will follow a procedure called coordination of benefits to do this properly to maximize your benefits and to minimize your out-of- pocket expense, however we must follow the rules of the plan.

• Vision plans have benefits for vision wellness exams, along with material benefits for eyeglasses or contact lenses. Vision plans do not cover medical eye care (the diagnosis, management or treatment of eye health problems like dry eye, macular degeneration, diabetes, or cataracts). It provides a prescription for glasses and provides no medical care or advice. If you have a medical complaint you want addressed by the doctor, vision plans will deny the claim. If a medical condition is found to be the cause of visual impairment, we must use medical insurance per vision plan rules, and referrals may be send to specialists. Medical insurance must be used for medical eye care.

• Because vision benefit plans and medical insurance plans each have separate rules and coverages, multiple visits may be required to treat multiple concerns.

• Having an insurance plan is not a guarantee of full or partial coverage. If some fees are not paid by your insurance(s), we will bill you for them, such as deductibles, co-pays, or non-covered services as detailed by the insurance contract(s).

 

We DO NOT accept WELLSENSE or WELLSENSE-MEDICARE ADVANTAGE

Patient Reviews over the past 5 years

 

 

 

– We are fully compliant with the “no surprises act” (NSA) of 2022.