North Office: (512) 250-2020 Central Office: (512) 454-2020

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Insurance FAQs
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Insurance FAQs

Austin Eye accepts most types of medical insurance plans. As insurance policies vary greatly, we recommend that you check with your insurance carrier regarding the details of your coverage prior to any visit at Austin Eye. We are considered specialists and file accordingly.

As a guide for our patients, Austin Eye has provided some common insurance definitions in the table below. This information should be used only as a guide. Specific details or questions regarding your medical insurance should be requested directly from your specific insurance provider.

INSURANCE COVERAGE
Medicare and Commercial Plans Yes. We are in-network with most commercial plans, Medicare, and Medicare replacement plans/supplements.
*These plans can be PPO/POS/EPO or HMO, see below*
Examples include (but are not limited to): Advantage plans, Aetna, BCBS, Cigna, Humana, Tricare, UHC.
Medicaid and other Government Funded Plans No. We are not providers for Medicaid and other various government funded plans. We are legally unable to see patients with these plans. Examples include (but not limited to): Traditional Medicaid and QMB, Sendero, Ideal Care, MAP, CHIP, Ambetter.
Vision Plans No. We are not providers for ANY vison plans or vision benefits. Examples include (but not limited to): VSP, Superior Vision, EyeMed, Guardian.
COMMON INSURANCE DEFINITIONS
HMO HMO plans require you to obtain a referral from your primary care physician prior to your eye appointment. What if I don’t have a referral? Visits without a referral are considered unauthorized and full payment falls on the responsibility of the patient at the time of the appointment.
PPO/POS/EPO In most cases, you do not need to obtain a referral prior to being seen. You are responsible for any specialist copay, co-insurance and/or unmet deductible.
Deductible A deductible is the amount you are financially responsible for before your insurance company starts to pay for your medical services. You will be subject to your contracted deductible with your medical insurance. With an unmet deductible, most insurance will apply office visits/surgery towards your deductible.
Copay A copay is the set dollar amount you pay upfront for any office visit. This amount is usually listed on your card next to “specialist”.
Coinsurance A coinsurance is the percentage of the total cost of your medical service. Your coinsurance will apply after you have met your annual deductible.
Refraction Refractions are performed to generate glasses/contact lens prescription and for diagnostic purposes. The refraction is $45 and billed separately from your medical exam and is not covered by most medical insurances.