Insurances Accepted

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Insurances Accepted

At the Honolulu Eye Clinic we accept a wide variety of insurance plans.  Below you will see a list of the insurance plans that we accept.  If you have any questions in regards to your specific plan we suggest you contact your insurance company directly as there are many facets to your insurance plan that we may not have access to.

Interested in learning more about the difference between medical and vision insurance and which will be used for your eye exam?

Click to Learn More About Medical vs. Vision Insurances
VISION INSURANCE

It is important that you understand that your Vision Plan (VSP, HMSA Vision) covers ROUTINE well-eye exams only (nearsightedness, farsightedness, and normal astigmatism) which includes the refraction to determine your eyeglass prescription. Some plans provide a limited contact lens evaluation benefit while other plans do not provide any contact lens evaluation benefit. As part of your routine well-eye exam, our doctors examine your eyes for many conditions and diseases including glaucoma, dry eyes, cataracts, retinal holes or tears, diabetic and hypertensive eye diseases, just to name a few.

If your routine well-eye exam reveals a medical condition or disease related to your eye that requires specific counseling, documentation, follow-up care, regular monitoring or referral to a surgeon, or if the exam is related to a pre-existing medical condition such as cataracts, glaucoma, diabetes, dry eyes, etc., then your visit is NOT COVERED by your Vision Plan. For instance, if you come in for a routine well-eye exam simply because you are having difficulty seeing with your current glasses, but it is found that your reduced visual acuity is due to developing cataracts, then your exam would have to be billed to your medical insurance. Unfortunately, the doctor cannot tell if medical eye conditions exist before you are thoroughly examined.

MEDICAL INSURANCE

The good news is that your Medical Insurance can be used when an eye-related medical problem such as eye injuries, pink eye, double vision, headaches, cataracts, dry eyes, complications from diabetes or high blood pressure (among many others) is found during the course of the eye examination. You do not need a vision benefits rider on your medical insurance to be covered for a medical eye condition, as it is covered in a similar fashion to the way that a visit to any medical specialist is covered. In these cases, your Medical Insurance will be billed for the eye exam even though a Vision Plan may also be in effect because you are being treated for a medical condition.

Your Medical Insurance co-pays and deductibles prevail and must be paid at the time of your exam. If a referral is required by your insurance plan in order to see a specialist, then you are responsible to obtain it. Believe it or not, a comprehensive examination that is medical in nature does not include the refraction. Nearsightedness, farsightedness, astigmatism, and the need for reading glasses are not considered a medical diagnosis.  Medical insurance plans will deny this portion of the examination. If you have both medical and vision insurance plans, our office will coordinate the benefits to minimize your out-of-pocket costs. You can still use your Vision Plan material benefits towards the purchase of eyeglass frames, lenses or contact lenses based on your specific plan’s allowances

At times it can seem like a complicated process, but these are the rules set by your insurance company. We would be happy to answer any questions that you may have about your insurance coverage.

If you would like to save time at your appointment, please click on our forms button below to complete your registration and health history forms in advance of your appointment. Please print them and bring them with you. Please keep in mind there may be additional forms for you to fill out and/or read and sign in our office.

For patients who currently are not covered under any insurance plan, we do accept private pay (self-pay) patients. Please feel free to contact us if you cannot find your insurance company listed here and we will be able to assist you.

Click for a list of Insurances Plans we are on Par with for Medical Exams
• HMSA – Akamai Advantage Plans
• Aetna Life and Casualty*
• Blue Cross/Blue Shield*
• Champus VA
• Cigna Insurance
• Hawaii Laborers
• Healthnet
• Healthcare Management Company PPO (HMA)*
• Healthcare Management Company HMO (HMA)*
• Hawaii Management Alliance Association (HMAA)
• Hawaii Medical Service Association (HMO)
• Hawaii Medical Service Association (PPO)
• Health Plan Hawaii (HMSA – HPH)
• Hawaii Medical Service Association (HMSA Quest)
• Kaiser Added Choice*
• Medicare*
• Tricare*
• University Health Alliance (UHA)
• United Healthcare Medicare Complete
• United Healthcare

Insurances accepted only for exam, NOT for glasses or contact lens purchase

Click for a list of Insurance Plans we are on Par with for Vision Exams
• HMSA – Akamai Advantage Plans
• Hawaii Medical Service Association (HMO)
• Hawaii Medical Service Association (PPO)
• Health Plan Hawaii (HMSA – HPH)
• Hawaii Medical Service Association (HMSA Quest)
• University Health Alliance (UHA)
• United Healthcare
• Vision Service Plan (VSP)
Click for a list of Insurance Plans we are on Par with our Optical Shop (glasses and contact lenses)
• VSP
• UHA, must be Vision 100
• HMSA QUEST
• HMSA
• HMSA-OAI
• HMSA-OAJ
• HMSA-OAO
• HMSA-OAW
• HMSA-OCK
• HMSA-OCN
• HMSA-OCR
• HMSA-OCZ
• HMSA-ODA
• HMSA-ODB
• HMSA-ODC
• HMSA-ODD
• HMSA-ODE
• HMSA-ODF
• HMSA-ODG
• HMSA-ODJ
• HMSA-OOG
• HMSA-OON