Do I use vision or medical insurance for my visit?

The eyes are unique in that they have to very separate components: their visual ability, and their health.  Depending on the primary reason for the visit, either vision or health insurance will cover the visit.

Vision Insurance:  This covers routine vision exams.  This includes finding prescriptions for glasses, (and in some cases contact lenses) as well as an eye wellness exam where we screen for a wide variety of conditions such as macular degeneration, glaucoma and cataracts.

Medical Insurance: This covers eye emergency type visits such as trauma, foreign objects in eyes, pink eye, and dry eye.  Medical insurance also covers the treatment of more chronic conditions such as glaucoma. 
 

If you are unsure, just ask our receptionist.  Our staff will be happy to help guide you through the process and help you utilize the proper insurance.  No need to leave downtown Santa Cruz for great eyecare!

Since I've been to you before, what information do you have on me to accelerate the booking, check-up and prescription process?

If we have seen you before, we already have all your previous medical information on file.  In most cases, insurance information doesn't change year to year.  Unless you have had any major medical or vision changes, we will be able to get started right away saving you some time and effort.  If you schedule online, no need to fill out the "pre-exam paperwork."  If you are calling to schedule an appointment (831.426.7172) just let our receptionist know that you are a returning patient, and we will pull all your previous information.  No need to come in early.  We strive to be on-time with all our appointments to value your time.  

I've recently visited but need a secondary pair of glasses. Can you organize and bill for this?

Most people have a few pairs glasses, whether it be sunglasses, computer glasses, or sports specific glasses, we understand that your lifestyle has unique visual requirements and we can help recommend the proper eyewear.  If you have recently come in for an exam, this process is easy.  We have your prescription on file and all we need to do is assist in selecting the proper frame.  Our talented opticians will guide you through this process and take digital measurements of how the frame fits on your face to customize the lenses for you and the frame you have selected.  If you have a favorite set of frames already, lenses can be customized for most good quality frames.  All of this can be done easily from our office right in Midtown Santa Cruz.

Most vision insurance plans offer significant discounts for secondary pairs and our staff will help you figure out how to optimize your benefits.

Can I send you records of my eye history to-date or do you start from scratch at the first appointment?

Yes!  If you have previous records including medical eye evaluations, glasses or contact lens prescriptions or other optometry or ophthalmology notes, it is helpful if you can send those to us or bring them when you come to visit us at Midtown Optometry.  Baseline tests will help us better manage any eye conditions, and a contact lens or glasses history will allow us to understand how your vision has changed over time.  For contact lens wearers, it is also useful to bring the boxes from the contact lenses you are currently wearing since this will save you a follow-up visit.  Often we have new lenses available in your prescription if we need to give free trials to evaluate changes.

My insurance plan covers the entire family, how can you accommodate for us?

Often times the entire family will be covered under the same vision and medical insurance.  We can check family eligibility for vision exams as well as glasses and contact lenses.  Children should have a comprehensive eye exam before starting school at age 4 or 5 at the latest.  A school screening or vision exam at the pediatrician is not as comprehensive as the workup from an optometrist.

We can often book families all in the same time block to make things easier on parents.

When do you need to see my medical insurance card?

While we are able to look up vision insurance online by searching your name, date of birth and last 4 digits of your social security number, we do require an insurance card to bill for medical eye exams such as infections, trauma, follow up for macular degeneration or glaucoma or other medical conditions.  Even if you are checking in for your routine vision appointment, we still request a copy of your medical insurance card to keep on file so we know where you will be covered in case of a medical eye issue.  We are always happy to recommend a good doctor in our network even if we cannot bill your specific medical insurance.  We do accept Medicare at Midtown Optometry.

If you want us to check your eligibility for your vision plan, we can do that over the phone, or via email.

I'm in need of eyecare but don't know what my insurance will allow for, can I book?

We are contracted with almost all vision insurance plans as well as many health insurance groups.  For routine eyecare, we will bill your vision insurance on your behalf.  For medical visits relating to your eye health, we are able to bill any PPO insurance including Medicare.  No need to leave Midtown Santa Cruz for fantastic eyecare.  Often times your insurance will have a copay for the visit that you would be responsible for at the time of the exam.  Many vision insurance plans will also cover glasses or contact lenses.  While there are fully covered options available, many plans will require an out-of-pocket payment for overages on premium lenses and frames.