Insurance Plans
We participate with VSP, Medicare, MES, VCP, Sight for Students, VSP's RNP, Tri-Care, Tri-West VA Community Care, and Champus
We are one of the few offices that participate with Medi-Cal (Medicaid) through:
1. VSP's Medi-Cal through Health Plan of San Joaquin
2 Health Net's Envolve.
3. Now accepting "straight" Medi-Cal
Check with our staff if you have other types of coverage. Recently we have found two companies that offer care even better than the above listed and have accepted them as payment in full within the terms of the policies.
We accept attorney's contingency services with $500.00 up front.
We participate with VSP, Medicare, MES, VCP, Sight for Students, VSP's RNP, Tri-Care, Tri-West VA Community Care, and Champus
We are one of the few offices that participate with Medi-Cal (Medicaid) through:
1. VSP's Medi-Cal through Health Plan of San Joaquin
2 Health Net's Envolve.
3. Now accepting "straight" Medi-Cal
Check with our staff if you have other types of coverage. Recently we have found two companies that offer care even better than the above listed and have accepted them as payment in full within the terms of the policies.
We accept attorney's contingency services with $500.00 up front.
About VSP:
Did you know you can personally purchase VSP eye care insurance and you do not have to go through an employer. Here's the skinny:
https://www.saveonvision.com/l/DORAHAUPT/?email=billfcovd%40gmail.com
Why not consider the best vision care insurance in the world?
Medicare recipients be ware
Carefully look at the difference between Medicare Supplementary insurance and the "so called," Advantage plans. Some of our patients have lost thousands of dollars in Medicare benefits their Advantage plan denied.
Carefully look at the difference between Medicare Supplementary insurance and the "so called," Advantage plans. Some of our patients have lost thousands of dollars in Medicare benefits their Advantage plan denied.
In an Advantage plan you have Medicare benefits in name only. The advantage plan (All are HMO's) manages your Medicare benefits as the plan sees fit. In other words, they deem whether you receive them. Remember these benefits are available to all Medicare recipients. Yet, their panel doctors are pressured to either declare you don’t have the diagnosis or don't need the treatment and deny the benefits
The Advantage plans tout extra services like eyeglasses and dental. Most we have seen are poor quality. The most unscrupulous of Advantage plans offer you a vision plan of exam only that Medicare would have covered anyhow.
However, some Supplements offer extra services.
However, some Supplements offer extra services.
Yes, a Supplement often costs more, but is it worth the thousands in denied services to select an advantage plan?
If you have Medi-Cal be VERY careful determining an Advantage plan as Medi-Cal picks up the majority of your Medicare co-pays.
If you have Medi-Cal be VERY careful determining an Advantage plan as Medi-Cal picks up the majority of your Medicare co-pays.
A supplement keeps you signed up as a Medicare recipient with its vast benefits and a private supplement insurance picks up the 20% co-pay for office visits.
A Medi-Cal/Medicare recipient patient who has been a part of our office more than 20 years is an example. A salesman convinced her to abandon her Medicare and Medi-Cal plans to become an “advantage” plan member.
She did not tell us of the switch so we naturally scheduled her as a Medicare/Medi-Cal patient. We must submit to Medicare first. A month later Medicare informed us she was not a part of Medicare but an “advantage” plan. It took searching to find her “advantage” plan. Now a month later, the “advantage” plan refused her bill. The “advantage” plan had a very limited doctor panel that did not include us. She enjoyed no-cost visits the past 20 years. We accept Medicare/Medi-Cal reimbursements as full payment. Now she is stuck with a bill. Yes, we’ll help her with the bill. Just what advantage did she get?
We have found Medicare to be an excellent program for our eligible patients.
It is a shame deceptive advertisements appear during renewal time. Health insurance is confusing enough.
These are our observations within our practice and limited to eye care benefits, but I imagine the same may exist in other care.
These are our observations within our practice and limited to eye care benefits, but I imagine the same may exist in other care.
To Our Most welcome Medi-Cal patients:
Some of you have complained about your frequency of visits. Please note. Again I say: PLEASE NOTE: We gladly accept Medi-Cal recipients. BUT we must adhere to Medi-Cal strict policies. Those policies do not necessarily reflect our policies.
Both Medi-Cal (Medicaid in CA) and Medicare are administrated by CMS. They allow ONLY ONE SERVICE PER VISIT. Yes, on many occasions we could easily provide more than one service and do for private patients.
We have, against advice, included Medi-Cal coverage. Kindly respect our dedication and realize we must adhere to CMS guidelines.
Some of you have complained about your frequency of visits. Please note. Again I say: PLEASE NOTE: We gladly accept Medi-Cal recipients. BUT we must adhere to Medi-Cal strict policies. Those policies do not necessarily reflect our policies.
Both Medi-Cal (Medicaid in CA) and Medicare are administrated by CMS. They allow ONLY ONE SERVICE PER VISIT. Yes, on many occasions we could easily provide more than one service and do for private patients.
We have, against advice, included Medi-Cal coverage. Kindly respect our dedication and realize we must adhere to CMS guidelines.
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More Good News to each of our adult Medi-Cal patients. |
Department of Healthcare Services Medi-Cal
Optician Services Restored as Medi-Cal Benefits
Effective for dates of service on or after January 1, 2020, optician services (eyeglasses) previously eliminated (2009)are reinstated as Medi-Cal benefits for Medi-Cal recipients 21 years of age or older
Optician Services Restored as Medi-Cal Benefits
Effective for dates of service on or after January 1, 2020, optician services (eyeglasses) previously eliminated (2009)are reinstated as Medi-Cal benefits for Medi-Cal recipients 21 years of age or older
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And now the bad news!
It is taking the State lab (in our prison system) way too long to manufacture your glasses. Six week waits are common. We have called (they won't answer anymore). The governor granted adults eyeglasses benefit again (a good benefit for adult recipients), but did not plan for the demand it created. Six months ago they added private labs to reduce the first back log. But once they caught up, they ended the private labs. So here we are again! They are blaming COVID, which seems like a stretch of the truth and an excuse. |
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Please, we have done all we can to motivate the lab. We have to follow Medi-Cal regulations we have to order Medi-Cal glasses from the state lab), and the delay has nothing to do with us. There is one thing that may help. All of us need more than one pair of glasses in case of breakage. Our labs are on schedule(within 10 days). May we suggest you consider of a second pair. We even have a value plan to help your finances, where you can get an entire pair of quality glasses for $80.00.