Insurance & Payment FAQs
Get clear answers about Medicare, Medicaid, private insurance, required documents, and payment options for ocular prosthetic services.
We’re Here to Help
We understand that insurance and billing questions can feel overwhelming. Our team is available to help verify your benefits, explain your coverage, and guide you through the required steps before your appointment.
Frequently Asked Questions
Answers to Common Insurance Questions
Browse the most common questions about insurance coverage, required documents, and payment responsibilities.
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Medicare
Yes, we work with Medicare. Medicare covers a portion of prosthetic eyes and related services. Prior to your fitting, a letter of medical necessity from your referring ophthalmologist is required. Doctors Written Orders (DWO) or Standard Written Orders (SWO) must be obtained prior to services rendered by our office.
Medicaid
Yes, we work with Medicaid. Ocular Care Prosthetics, LLC is a provider of service with the New York State Medicaid Program.
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We do not accept private insurance. We are not contracted with any commercial insurance plans. This may change in the future.
Patients may be seen as self-pay and may submit claims for possible out-of-network reimbursement.
At present time, we are completing Medicare and Medicaid credentialing.
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Most insurance plans require a letter of medical necessity from your ophthalmologist or referring provider. We’ll help verify your eligibility and submit for authorization when needed.
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Please provide the following:
A letter of medical necessity from your provider
A copy of your current insurance card (front and back)
Any prior authorization forms, if applicable
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We accept cash, check, and credit card. Coinsurance, copayments, and deductibles are due at the time of service.
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No. Not at this time.
Before Your Appointment
What You May Need to Prepare
Having the right documentation ready helps us verify your benefits and support a smoother visit.
01
Letter of Medical Necessity
A written statement from your ophthalmologist or referring provider may be required for coverage and authorization.
02
Insurance Card
Please provide a current copy of your insurance card, including both the front and back for verification purposes.
03
Prior Authorization
If your insurance plan requires approval before treatment, please bring any prior authorization forms available.
Payment Responsibility
Clear Expectations Before Your Visit
Depending on your insurance plan, copayments, coinsurance, deductibles, or non-covered balances may be due at the time of service. Our team is happy to help explain your coverage before your appointment whenever possible.
What payment methods do you accept?
We accept cash, check, and major credit cards. Coinsurance, copayments, and deductibles are due at the time of service. As we are not in-network with all insurance providers, patients may be responsible for payment at the time of their visit. For your convenience, we accept Visa and MasterCard.
CASH
CREDIT CARDS
CHEQUE
Need More Help?
Still Have Insurance Questions?
Our staff is here to help you understand your coverage, confirm your benefits, and answer billing questions before your visit.