Eye Specialists of Mid Florida accepts most insurance and vision plans. We also participate with many Provider Networks.
List of some Insurances Accepted here at Eye Specialists of Mid Florida, P.A.
(Call for an appointment and plan acceptance verification today, 800-282-3937).
Vision Insurance
- Access Vision
- Avesis
- EyeMed
- First Look Vision (AlwaysCare)
- NVA (National Vision Administrators, LLC)
- Safeguard Vision (Metlife)
- Safety Eyewear Program – Lakeland
- Spectera
- VBA (Vision Benefits of America)
- Versant Health (Davis Vision)
- Versant Health (Superior Vision)
- VSP (Vision Service Plan)
Medical Insurance
- AARP Medicare Complete PPO/HMO
- AARP Medicare Advantage PPO/HMO through Wellmed
- Aetna Commercial PPO/POS/EPO
- Aetna Medicare Advantage PPO
- Aetna Advent Health Employees
- Angels Care of Eloise
- AVMED
- Florida Blue
- Blue Cross Blue Shield (BCBS) – Blue Choice PPO, Traditional PPO, Blue Select PPO
- Blue Cross Blue Shield (BCBS) – Health Options Commercial PPO/HMO
- Blue Cross Blue Shield (BCBS) – Health Options Medicare Advantage PPO/HMO
- Cigna Commercial PPO/POS/EPO
- Cigna Allegiance – Orlando Health Network Only – Please call for Surgical Appointments
- Cigna Baycare *Baycare Health Systems* (Baycare & Winter Haven Hospital)
- Cigna Great West
- Coventry – Aetna
- DBS (Division of the Blind Services)
- Evolutions
- Eye Care America
- GEHA
- GHI
- Health First Health Plans – Sunsaver Medicare Advantage HMO
- Humana Commercial PPO/POS/EPO/HMO
- Humana Medicare Advantage Gold Choice or Gold Plus PPO/POS
- Humana Medicare HMO – Please call for Location Specific Appointments
- Humana Military Tricare / Champus (Prime & Select)
- Meritain Commercial
- Meritain – Polk Healthcare
- MEDICAID – Full, Share of Cost, QMB
- Medicare
- Medicare / Railroad Medicare
- Medi-Share
- Samaritans Touch – Please call for Location Specific Appointments
- United Healthcare Commercial Plans – Choice PPO/HMO, Choice Plus, POS/EPO, Select Plus, Options, The Villages
- United Healthcare AllSavers
- United Healthcare Shared Services
- United Healthcare Golden Rule, Preferred Care Partners, Global
- United Healthcare Dual Complete Medicare Advantage
- UMR
- VOC Rehab (Florida Department of Education)
- Veterans-Optum VA Community Care (Old TriWest)
- WeCare of Central Florida
When you call for an appointment, please have your insurance card available. Some of the information required by our appointment schedulers will only be found on your insurance card. We will also ask to see your card when you check in for your appointment. We do this not to inconvenience our patients but to confirm their insurance and help their visit move as smoothly as possible.
There are many different insurance plans that are offered, and we continue to add new insurance plans on a regular basis. Therefore, the most accurate way to find out if we accept your insurance plan is to call our office at 800-282-3937. For additional information, please read below.
Insurance Information Details
Eye Specialists of Mid-Florida is providing this information to help answer any questions you may have concerning our billing practices and insurance procedures. We are always willing to discuss any financial matters with you and assist in any special arrangements should the need arise. Eye Specialists of Mid Florida, P.A. (ESMF) believes that the most important issue is that you receive the best and most appropriate eye care. Many of the eye diseases seen in our clinic can cause permanent visual impairment unless treated promptly. Our foremost concern is the health of your eyes.
Medicare
ESMF participates (i.e., accepts assignment) with the Medicare program. What this means is our staff will prepare and submit your claims directly to Medicare on your behalf. We are reimbursed directly at 80% of the established Medicare fee schedule. You will then be responsible for the remaining 20% plus any annual deductibles that have not been satisfied. If you have supplemental insurance, it will be filed automatically after Medicare has paid. If your supplemental insurance has not been paid after one month, the balance due on your account will be your responsibility.
Medicare Advantage
If you have enrolled in a Medicare HMO or a Medicare Replacement Plan, we will communicate directly with the carrier on your behalf in accordance with the network guidelines. However, you may be required to obtain referral forms prior to your visit. The Medicare Advantage plans are required to provide the same benefits as traditional Medicare; however, it has been our experience at times to have payments either delayed or refused for certain procedures, e.g., iStent. We have found it necessary to request a signed acknowledgment from our patients and request a refundable deposit for services rendered.
Managed Care (HMO, PPO, etc.)
ESMF participates with many prepaid health plans. Due to the ever-changing number of plans available, we are unable to list all of them on this site, however, feel free to ask a staff member if we participate with a specific provider or contact your health plan provider directly. ESMF and Eye Surgery and Laser Center (ESLC) (the ambulatory surgery center where we provide surgical services) are separate providers; consequently, they may have different agreements with various health plans. ESMF and ESLC make every effort to contract with the same providers; however, we cannot guarantee this will always be the case.
Please read all the literature provided by your health plan regarding patient responsibilities. Some health plans require you to obtain a referral authorization form before we can provide services. Most plans require a co-pay and/or deductible payment to be made at the time of service. We are contractually obligated to collect your co-pay prior to your visit with the doctor. If you are undergoing a procedure, your insurance company may require that you pay two co-pays, one for the doctor’s service and one for the surgery center or supplies. We do not have any control over this policy.
Private Insurance
As a courtesy, ESMF will prepare and submit insurance claims on your behalf for the services provided. Please be aware that you are ultimately responsible for your account, as we may not have a contractual relationship with your insurance carrier. If ESMF has not received a payment or determination from your insurance carrier within six weeks, you will be responsible for payment.
No Insurance
Our policy is to provide quality care to all of our patients. We do understand the financial problems that many families face today. In some cases, we are able to assist in obtaining alternative financing through charitable organizations or provide information on other available programs.
Billing Procedure
Like many other businesses, we encourage payment at the time of service. Payment for medical care differs somewhat in that with insurance coverage, it becomes the primary payer for a large portion of the services provided. The balance due, depending on your coverage, is your personal responsibility and we will expect payment at the time of service. If there is a problem or if you have questions with regard to the care you received, please contact us immediately.
