Roosevelt Vision is a preferred provider and can bill in-network with these vision plans:
AARP (Medicare secondary)
Blue Cross Blue Shield
HMA (Healthcare Management Administrators)
KPS Health Plans
LifeWise of Wa
Premera Blue Cross
RGA (Regence Group Administrators)
Regence Blue Shield
Sound Health Aetna
Additional vision plans we are out-of-network with but can bill on your behalf:
VSP - Vision Service Plan
How this works: When you select glasses or contact lenses in our office we will have a printout of your out-of-network benefits and will review this with you at the time of service. We will submit the out-of-network claim on your behalf. You will pay Roosevelt Vision at the time of your visit and will be reimbursed by your insurance within 3 to 4 weeks.
When you schedule your appointment, we will verify all of your allowances in advance of your visit and if you, or Roosevelt Vision, have any questions we will certainly be transparent with you about your plan.
UNDERSTAND THE DIFFERENCE
Vision insurance covers routine comprehensive eye examinations. This includes eye refraction (a measure of astigmatism, nearsightedness, or farsightedness) to determine your prescription for eyeglasses or contacts. Vision insurance may not cover the contact lens portion of a routine exam; check with your insurance provider to see if they offer discounts.
Comprehensive exams screen for certain medical conditions, including:
Hypertensive Eye Diseases
Retinal Holes & Tears
However, vision insurance generally does NOT cover further medical testing, treatment, or follow-up for these conditions. If a medical diagnosis is made, we are required to submit the examination to the medical, not vision, insurance.
If you wish to purchase glasses or contact lenses at your visit, please schedule a Comprehensive Eye Exam. Please note that most vision plans will not cover 100% of the costs of glasses or contacts, so expect some out-of-pocket costs.
Medical insurance pays toward eye care visits that are medical in nature. This includes emergency visits or visits focused on a specific eye problem, including:
Retinal Holes & Tears
Optic Nerve Disorders
Hypertensive Eye Issues
Medical insurance may also pay toward a comprehensive examination if there is a medical reason for it (such as diabetes, cataracts, or any of the previously listed reasons). A comprehensive examination that is medical in nature does NOT include the refraction to determine your prescription for eyeglasses or contacts.
If you have both medical and vision insurance plans, our office will coordinate the benefits to minimize your out-of-pocket costs.
If the purpose of your appointment is for a diagnosed eye-related medical condition or disease, then notify the appointment scheduler you need a medical eye exam/office visit and we will expect to bill your medical insurance. If your medical insurance requires a referral please contact your Primary Care Physician/PCP to ensure one is sent to us before your appointment. We can attempt to initiate the PCP referral request on your behalf, but typically, your PCP will require your approval.