Insurance and Financing for Retina Care
Medicare and Medicare Advantage
Both traditional Medicare and Medicare Advantage Plans can cover the retina treatments you may need, yet the rules differ. Knowing these differences helps you avoid surprises at the time of care.
Traditional Medicare covers intraocular injections with FDA-approved drugs such as EYLEA and LUCENTIS. These medicines are often needed to save vision in conditions like macular degeneration.
In most cases, Medicare Advantage Plans first require the use of Avastin, a drug not FDA-approved for use in the eye. Only if Avastin fails will the plan consider EYLEA or LUCENTIS.
Each year you can change your Medicare or Medicare Advantage Plan. Reviewing coverage rules for eye injections before you switch can help keep your treatment on track.
Insurance Plans We Accept
Our practice participates with a wide range of medical insurance carriers so you can receive care without extra stress.
The following plans are currently in network:
- Medicare
- United Healthcare
- Aetna
- Blue Cross Blue Shield
- Cigna
- Humana
- AARP
- Mutual of Omaha
- Keystone Health Plan East
- Tricare for Life
- Independence Blue Cross Blue Shield
- Bankers Life
- Colonial Penn
- Personal Choice
- New Era Life Insurance
Choosing the Right Plan
Selecting a health plan is a personal choice that should balance cost, coverage, and access to FDA-approved eye drugs.
Look at monthly premiums, deductibles, copayments, prescription coverage, and yearly out-of-pocket maximums when reviewing plans.
Make sure the plan you pick allows you to receive EYLEA or LUCENTIS without first failing a different drug, if that is important for your treatment.
If you choose a Medicare Advantage Plan, confirm that our clinic is on the provider list and that retinal injections are covered.
Please tell us about any insurance change before your next visit so we can update your records and prevent billing issues.
Frequently Asked Questions
Below are answers to common questions patients ask about insurance and retina care.
Many Medicare Advantage Plans use step therapy rules. They start with Avastin because it costs less, and they approve EYLEA or LUCENTIS only if Avastin does not control your condition.
Yes. During the annual enrollment period you may return to traditional Medicare and add a supplemental policy and Part D drug plan.
Copay amounts depend on your specific plan. Reviewing your summary of benefits or contacting your insurer will give the exact figure.
Bring your new insurance card and any referral or authorization documents. This allows us to bill correctly and keep your treatment on schedule.
We Are Here to Help
Your vision matters, and so does clear information about paying for care. Reach out with any questions about coverage, and we will work together to keep your eyes healthy and your costs understood.
I more than luckily would be blind if not for Dr Kleiner. I live in a time that this is possible, so appreciate him and the work he does.
Betty Jane Foglio
Staff was very friendly and efficient. I was a new patient add on and it didn’t feel that way.
F.T
Dr. Kleiner is the absolute best. I wouldn’t trust my eyes to anyone else. He has saved my eyesight.
Mary DeMeno
Dr. Greene is the greatest doctor I know. His skills are unbelievable. His personality is the best I have ever seen. We love you Dr. Greene. You have earned 100 stars in our family!!
william snodgrass
Dr. Kaplan is pleasant and compassionate. Perhaps more importantly, she is well educated and knowledgeable. Everyone on the staff is courteous and efficient. Highly recommend!
Ruth Horwitz