Insurance Information

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At Ophthalmology Associates, S.C., we strive to make quality eye care accessible and stress-free for our patients. We accept a wide range of insurance plans and work closely with you to understand your coverage, co-pays, and billing options. Our team is here to guide you through every step, ensuring your focus remains on your vision and health.

Payment

Ophthamology Associates S.C accepts personal checks, cash or payments by MasterCard, Visa, and Discover. Credit card payments may be taken in person or over the phone.

Disclaimer: This is not a comprehensive list of all in network plans, nor does this list guarantee payment. Please confirm with your insurance company that your plan is in network prior to scheduling your appointment.

Insurance Partners We Accept

At Ophthalmology Associates, S.C., we accept most major insurance plans. Below is a list of common insurance providers we work with:

Commercial Insurance Plans

Aetna
Anthem Blue Cross Blue Shield
Centivo
Cigna
Humana
Maritain
Quartz
United Health Care

Medicare Plans

Medicaid / State Plans

Please note that this list may not be all‑inclusive. Coverage can vary by plan. We recommend contacting your insurance provider or our office to confirm coverage prior to your appointment.

Medicare Programs

Medicare
AARP Medicare Complete (HMO & Essential HMO)
Aetna Medicare Advantage
Anthem Mediblue Select HMO
Anthem Medicare Preferred (Core Ppo, Select Ppo, PPFS)
Care Improvement Plus of WI
Humana Medicare (Choice, Employer, PPO, Gold, PFFS, PPO)
United Healthcare Medicare Community Plan
United Healthcare Medicare Solutions (PPO/HMO/POS)
United Healthcare Navigate (HMO Navigate, Balanced, Plus)
ICare Medicare
Network Health Medicare

Vision Programs

T19 Plans

T19/Forward straight
T19/Forward Badger Care Plus
Anthem Medicaid - medical only
Badger Care Plus Basic Plan
Badger Care Plus Core Plan
Badger Care Plus Standard Plan
Badger Care Plus Benchmark Plan
Badger Care Plus Benchmark Plan and Dental
Children's Community
Family Care/Community Care
Medicaid
Medicaid for Foster Care
Medicaid for SSI
Medicaid Purchase Plan/Purchase plan Waiver
QMB - Does not pay for refractions/glasses/routine
Chorus Community Health Plan
United Health Community Plan (AMERICHOICE)
Wisconsin Well Woman Medicaid
ICare

Marketplace Plans

Contracted Insurance Plans

AARP
Aetna PPO Medical only
Anthem Blue Cross PPO
Cigna
Common Ground ENVISION (including Aurora/Bellin)
GWH-Cigna
Health EOS (formerly HCN)
Health Payment Systems
Highmark Blue Cross (Anthem)
Humana (Choice, PPO, EPO, POS)
Midwest Security (UMR)
Multiplan
UMR
United Healthcare Navigate (Hmo Navigate, Balanced, Plus)
United Healthcare
United Health Integrated Services
Wheaton Franciscan Provider Network (WFPN)
Wheaton Franciscan Associate Network (WFAN)
WPS

Let's Talk About Insurance

Insurance has always been confusing, especially when it comes to eye care. It is possible you may have Vision Insurance in addition to your Medical Insurance.

We accept two insurance types:

Vision Insurance

Medical Insurance

How are they different?

Vision insurance is designed to pay towards a comprehensive “routine” eye examination that checks for, but finds no medical problem.

Medical insurance pays towards eye care visits that are medical in nature. Examples include: infections, floaters/flashes, loss of vision, glaucoma, cataracts, diabetes and many more.

What do they pay for?

Determining your eyeglass prescription is included in a comprehensive exam.
Vision insurance often pays for a portion of eyeglasses or contacts.

When there is a medical diagnosis like diabetes, cataracts, or the examples above, we are required to submit the exam to medical, not vision insurance.