Sunshine Optometry

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Maximizing Your Vision Plan Benefits: A Step-by-Step Guide

Navigating vision care benefits can be daunting, but we aim to simplify it for you. As an open-access provider, we ensure transparent costs and facilitate direct reimbursement from many vision plans via out-of-network benefits. This guide will help you use these benefits for eye exams, and purchases of prescription eyeglasses, contact lenses, and sunglasses.

Understanding Open Access & Reimbursement

Open access in vision care means we provide unrestricted services, allowing you to pay upfront and get reimbursed by your plan. This ensures transparent pricing and lets you choose the best eye care products without in-network limitations. Vision plans often promote specific products for financial incentives, which may not always be in your best interest.

Even better, as an open access provider, customers can maximize their vision plan benefits by combining them with promotions and discounts, resulting in even greater savings.

Unlike comprehensive health insurance, vision plans are discount or savings programs that are used towards routine care like exams and glasses at reduced rates. Even in-network, you'll pay premiums, copays, and costs beyond plan limits. Vision plans may help save on eye care but don't offer extensive financial protection.

You might find it surprising how much you're actually paying when you add up the premiums and copays, making you reconsider whether subscribing to these programs is worthwhile.

Step 1: Select Your Vision Plan

The first step in leveraging your out-of-network benefits is identifying your vision plan carrier. Some common carriers include:

  • Aetna

  • Anthem Blue View Vision

  • Cigna

  • Davis Vision

  • Eyemed

  • Humana

  • National Vision Administrators

  • Spectera

  • UnitedHealthcare Vision

    If you do not see your provider listed, we recommend contacting your vision plan company directly to understand how to apply for reimbursement for out-of-network services.

Step 2: Complete the Claim Form

After making your purchases in our store, our associates can help you submit a claim directly with most plans, ensuring a hassle-free process for you. If direct submission isn't possible, we'll provide a detailed service and purchase form. Just reach out to us via email or phone if you need receipts, and we'll gladly assist with the documentation for your claim.

Step 3: Get Paid by Your Plan Provider

After submitting your claim, all that's left is to wait for reimbursement. The processing time usually takes between 1 to 4 weeks, depending on your plan provider. While this step requires some patience, it's gratifying to receive a portion or even the full cost of your eye care expenses back.

To maximize your out-of-network vision plan benefits at our store:

  • Submit Promptly: Submit your claim promptly after your purchase or service to avoid delays.

  • Follow-up: If reimbursement is delayed, follow up with your plan provider for updates.

For assistance with the reimbursement process, our team is here to help. Here's to clear vision and smart savings!