Insurance Billing 

We will gladly bill your insurance for services provided in this office; however, we do need your help. It is impossible for us to know the exact terms and conditions of every insurance policy so be sure to review your policy before you come in for an appointment.

Please make sure you bring your most recent insurance card. Many companies change your identification number from time to time, and the correct number is essential in order for your claim to be processed correctly and in a timely manner.

  1. Know your coverage. Take the time to find out the amount of your co-pay, deductible, and any limitations or exclusions applying to your coverage. If you have any questions about your plan, call the 800 number on your card.
  2. Copayments and deductibles are required at the time of service.
  3. If you are NOT the subscriber on your plan, please provide the date of birth of the subscriber and your relationship to them.

We will do our best to work with you to ensure your insurance pays for services covered under your plan. However, each patient is responsible for payment of any and all charges.

Insurance Plans

We perform a wide range of examinations and services at MarinEyes. We are in-plan providers for many insurances, both vision plans and health insurances. There are several things you can do to make the insurance billing process easier, regardless of your specific plan.

Health Insurance

Prior to your departure, you will see our health insurance staff to check out. We participate in the Meritage Heath Network (formerly Marin-Sonoma IPA plans), most local, regional and national health insurance plans. We are Medicare providers. These plans generally cover medical or surgical eye conditions. However, these plans do NOT cover “routine” eye exams, glasses and contact lenses (there are exceptions, so check with your benefits manager to clarify your coverage). Our fee structure is similar to those at established practices throughout the San Francisco Bay Area.

Vision Plan Insurance

We participate in many “vision service plans” as well. In contrast with health insurance, these plans typically provide benefits for things such as routine exams, eyeglasses and contact lenses. However, coverage policies of these plans vary quite a bit and you need to check with your benefits provider to verify your benefits.

We participate with VSP, Medical Eye Services, and many other vision plans. These plans are generally separate from your health insurance. They generally DO cover “routine eye exams” (although the extensiveness of the covered service varies by plan, and may not include pupillary dilation), prescription and provision of glasses and contact lenses. They generally do NOT cover evaluation or treatment for eye diseases. If eye diseases are detected during the covered “vision exam,” you will need to make a separate follow-up visit for assessment and treatment of the disease problem. Typically the disease visit will be covered under your health insurance rather than the vision plan insurance. Please check with our Billing Department staff to clarify the nature of your vision plan coverage. Please verify our participation with your plan when you make your appointment. If you have some other insurance plan, you may be eligible for “out-of-plan” benefits. Check with your insurance company or benefits coordinator at work.

Here is a partial list of current contracted insurances:

Aetna Beechstreet Blue Cross
Blue Shield Cigna Compbenefits
Coventry First Health Great West Healthcare HealthNet
Interplan Medicare  MES (Medical Eye Services)
 PHCS Sutter Select VSP (Vision Service Plan)
Meritage Medical Network (formerly Marin-Sonoma IPA)

Payment is expected at the time of service

This is true regardless of what kind of insurance you have. We will assist you in processing your insurance claims. If your insurance requires a referral from your primary care physician, it is essential that you obtain this prior to your appointment and bring it with you on the day of your examination.