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!

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.