Vision Insurance and Eye Care Plans at Plaza Vision

The plans this practice works with, what a vision plan usually covers and what to bring to the appointment. Call the office: (626)359-3937

Almost every patient who calls asks the same question before they ask anything else: do you take my insurance. It is a fair question and it deserves a straight page rather than a sentence buried on a contact form. Plaza Vision Optometry works with a number of vision and health plans, including Aetna, EyeMed, One Health, Safeguard, US Health Care and VSP.

The honest caveat goes first, because it matters more than the list. Plans change their networks, their allowances and their rules every year, and two people carrying the same plan name can have very different benefits depending on which employer bought it. So treat the list as a starting point and confirm your own benefits with the office before your appointment. That call takes a couple of minutes and it is the difference between a clear bill and a surprise.

The Plans We Work With

These are the plans named on this practice’s own records: Aetna, EyeMed, One Health, Safeguard, US Health Care and VSP. If your plan is not on that list, it does not automatically mean we cannot see you — it means the arrangement is different, and that is covered further down this page.

Vision Plan or Medical Plan? They Are Not the Same Thing

This is the single most common source of confusion in an optometry office, and it is worth understanding before you book.

A vision plan is a benefits plan. It is built around the routine side of eye care: the annual eye examination, an allowance toward frames or lenses, and usually an allowance toward contact lenses. It is the plan that applies when nothing is wrong and you are simply keeping your prescription current.

A medical plan is your health insurance. It is what applies when there is a medical reason for the visit — an eye injury, sudden changes in vision, an infection, or monitoring the eyes because of a systemic condition such as diabetes. The examination looks similar from the patient’s chair, but it is billed differently because it is a different kind of visit.

Which one applies is determined by the reason for the visit and by what is found, not by which card you would prefer to use. If you are not sure which category you fall into, describe the reason for your visit when you book and the office will tell you what to expect.

What the visit is for	Which plan usually applies	What to bring
An eye exam	Usually your vision plan, unless the visit is about a medical eye problem	Your plan card or member details, and the name of the plan holder
New glasses	Your vision plan frame and lens benefit, where the plan includes one	Your current glasses and your prescription if it was written elsewhere
Contact lenses	Your vision plan contact lens benefit, which is usually separate from glasses	The boxes or the brand and power of what you wear now
A medical eye problem	Usually your medical plan rather than your vision plan	Your medical insurance details as well as your vision plan

What a Vision Plan Usually Covers

Most vision plans are built around the same three pieces: the eye examination, an allowance toward eyewear, and a separate arrangement for contact lenses. What varies is the size of the allowance, how often you are entitled to it, whether lenses and frames renew on the same schedule, and how much of the extras — coatings, progressive designs, specialty lens materials — come out of your own pocket.

Because those numbers differ so widely from plan to plan, this page does not publish them. Your plan documents and the office between them can tell you exactly what you have, for the year you are actually in.

Using a Plan for Glasses

A frame allowance is not the same as a free pair of glasses, and it is worth knowing that before you fall in love with a frame. In practice, the allowance covers the frame up to a limit, the lenses are handled separately, and the lens choices you make — single vision or progressive, the material, the coatings — are where the difference between plans actually shows up.

The optical staff here will tell you what your plan brings to a particular pair before you commit to it, not after. See the glasses page for what the optical carries, including designer frames and prescription sunglasses.

Using a Plan for Contact Lenses

Contact lenses are usually handled as an alternative to the frame allowance rather than in addition to it, and they carry their own examination because a contact lens prescription is a separate measurement from a glasses prescription. Some plans treat the contact lens fitting as a covered service and some treat it as a separate charge. Ask about that specifically, because it is the part people are most often surprised by.

If We Are Not In Network With Your Plan

Plenty of plans include out-of-network benefits, which means you pay at the time of the visit and your plan reimburses you afterwards against a receipt. The office can tell you what documentation your plan will want. It is more paperwork than an in-network visit and it is not a reason to skip an eye exam.

Before Your Appointment

Three things make the insurance side of a visit straightforward:

Call with your plan details before you come

Have the plan name, the member or subscriber ID, and the name of the primary subscriber if the plan is not in your own name. Benefits are checked against those, not against the plan name alone.

Say why you are coming

A routine annual exam and a visit about a specific symptom are billed differently. Saying which one it is when you book means nobody has to work it out at the desk afterwards.

Bring your current glasses or lenses

It is not an insurance matter, but it makes the appointment better, and it is the thing patients most often leave at home.

Booking

Use the contact page to reach the office with your plan details, or call ahead and ask. Locations are listed for Monrovia, Arcadia, Pasadena, Covina, Duarte and Sierra Madre.