Insurance does not always pay the entire cost of your care. Your plan may apply part of the charge to your deductible, copay, coinsurance, or a non-covered service.

If you have questions about how your insurance processed a claim, our billing staff can help explain your statement.

Yes, Rockingham Eye is accepting new patients. However, insurance coverages vary depending on held vision and health plans.

Eye exams fall into two categories: vision exams and medical exams. This matters because they serve different purposes and are billed to different types of insurance.

VISION EXAM (Routine Eye Exam)

Purpose: To determine how well you see and whether you need glasses or contact lenses. Vision plans focus on routine vision and eyewear benefits, NOT medical treatment.

May include:

• Vision testing (distance and near)
• Refraction (measuring your prescription)
• Basic eye health screening
• Glasses or contact lens prescription

Common reasons:

• Blurry vision
• Updating glasses or contacts
• Routine eye check with no medical problem

Insurance typically used:

• Vision plans (VSP, EyeMed, Blueview, Insight)

MEDICAL EYE EXAM

Purpose: To evaluate, diagnose, or manage a medical eye condition.

May include:

• Medical evaluation
• Dilated eye exam when medically necessary
• Diagnostic testing and imaging
• Treatment plans or prescriptions

Common reasons:

• Eye pain, redness, flashes, floaters
• Diabetic eye care
• Glaucoma, cataract, macular degeneration
• Dry eye disease, infections, injuries
• Follow-up visits

Insurance typically used: Medical insurance (Medicare, Medicaid or Commercial Plans)

Note: Refraction may not be covered by medical insurance and may be an out-of-pocket expense.

IMPORTANT INSURANCE REMINDER:

If a medical condition is evaluated or treated during your visit–even if scheduled as routine–the visit becomes a medical eye exam and must be billed to medical insurance.

VISION PLAN

• VSP*
• BLUE VIEW*
• EYE MED*
• CEC**
• CIGNA VISION (VSP/EYEMED)*
• METLIFE (VSP)*
• GUARDIAN (VSP)*
• UNIVIEW*

*Excludes Dr. Miller
** Excludes Dr. Small & Dr. Winpigler

COMMERCIAL

• TRICARE
• TRICARE FOR LIFE (SECONDARY)
• CCN-VA DEPT
• ANTHEM
• UHC COMMERCIAL
• CIGNA-JP FARLEY
• AETNA
• ANTHEM HEALTHKEEPERS
• UMR
• BCBS (ANTHEM as long as can send to local)
• GOLDEN RULE (UHC)

MEDICAID

• AETNA BETTER HEALTH (VSP)
• ANTHEM HEALTHKEEPERS PLUS
• MOLINA (MD only)
• WV MEDICAID (secondary)

NON PAR VISION PLANS

• DAVIS
• SPECTRA
• UHC VISION
• EYE MED SELECT
• SUPERIOR
• UNUM
• AETNA VISION
• BLUE VIEW SELECT

MEDICARE (ADVANTAGE PLANS)

• AETNA MEDICARE
• ANTHEM MEDIBLUE
• CLEAR SPRING HEALTH
• HUMANA
• UHC MEDICARE

MEDICARE

• UMWA HR (MEDICARE)
• MEDICARE
• RAILROAD MEDICARE

NON PAR

• UHC CCC MEDICAID
• AARP MEDICARE (UHC)
• AETNA MEDICARE HMO

Routine vision plans cover a routine exam to check eyesight, eye health, and whether your glasses or contact prescription needs to be updated.

Appointment times vary depending on the type of visit and testing you need. A comprehensive eye examination may take 1-2 hours. Some visits require testing and dilation before you see your doctor, Urgent patients may also need to be worked into the schedule, which can occasionally cause delays. We appreciate your patience while we give each patient the care they need.