Insurance Medicare Forms
Before Your Visit
Please bring the following items to your appointment:
As all insurance plans are different, please check with your benefits office to make sure you know which vision plan you are covered under, and what benefits might be available to you.
Contact Lens Associates is a provider for many insurance plans. Some of the more commonly known providers include:
If your medical spending card includes vision, it could be utilized for out-of-pocket expenses.
Medicare, usually, will cover the "Comprehensive Medical Portion: of an exam. Medicare does not cover the "Refractive" part of the exam. This is the portion of the exam where the doctor determines your prescription. This expense is out-of-pocket for the patient. Please bring your Medicare card with you to the appointment.
If we are not a provider with your vision insurance you may be able to self file. We will be happy to provide you with a statement containing diagnosis and procedure codes so you can file a claim yourself.
The following forms are available for you to download and print. If you are a new patient to our practice, please print out the Medical History Form, fill it out, and bring it with you to your appointment. Please Do Not email the Medical History Form to our office.