Insurance at Texan Eye
Texan Eye accepts most types of health insurance and a wide variety of Routine Vision plans. Whether you have Medicare, managed care, or private insurance, it is likely that your insurance will cover all or some of the services you receive. As insurance policies vary greatly, we recommend that you check with your insurance carrier regarding the details of your coverage. If you are a member of a Health Maintenance Organization (HMO), you will most likely need a referral from your Primary Care Provider (PCP) prior to being seen.
Not sure what your plan covers? Call us at
512.327.7000 before your appointment and our team will help verify your benefits and explain what to expect at check-in.
Common Insurance Plan Types
As a guide for our patients, Texan Eye has provided some common insurance definitions below. This information should be used only as a guide — specifics regarding your medical or vision insurance should be requested directly from your specific insurance provider.
What It Means for Your Visit
Medicare / Medicaid Managed Care
Many Medicare and/or Medicaid plans have moved to managed care plans (Medicare Advantage plans). While you may have a Medicare and/or Medicaid card, this is not your primary insurance card. Your primary insurance card may be a Blue Cross Blue Shield, United Healthcare, Amerigroup, or another insurance company. Please provide that card to the front desk if you are aware of your participation with a managed care plan.
PPO plans offer the choice of healthcare provider. You do not need to choose a Primary Care Provider (PCP) or obtain a referral to be seen. If you choose an in-network provider, you pay your typical copays, co-insurance, and deductible if applicable. If you choose an out-of-network provider, your costs may include higher copays, co-insurance, and a higher deductible.
HMO plans do not give you the option to choose your healthcare provider. You must establish with a Primary Care Provider (PCP) who will refer you to a specialist if needed. Visits without a referral are considered unauthorized and payment responsibility falls on the patient. The patient is ultimately responsible for obtaining and bringing all referral paperwork to their initial visit.
Depending on your plan, this may be a benefit you receive from your insurance company. If your plan offers vision benefits, there may be a third-party administrator for vision. Please make yourself aware of who administers your routine vision benefits, as it may not display under your health care benefits.
A deductible is the amount you are responsible for before your insurance company starts to pay for your medical services.
A copay is the set dollar amount you pay upfront for medical services.
A co-insurance is the percentage of the total cost of your medical service that you are responsible for. Your co-insurance usually starts after you have met your annual deductible.
