Medical & Vision Insurance

We accept a variety of medical and vision insurance. If your insurance is not on our list, please call our office to see if we can add your insurance. Please contact the number on the back of your card to verify we are a provider in your insurance’s network.

Please note that if you are self-pay, a $100 deposit will be required prior to the medical exam.

Self-pay routine eye exams are $89

Medical insurance will not cover the cost of a glasses prescription. For a refraction (glasses prescriptions) it is $35

Medical Insurance

We are only on the HMO plans listed below. All other plans would be out-of-network.

    • BlueCross BlueShield SC Preferred Blue (includes Federal & PPO)

    • BlueCross BlueShield SC State Health Plan effective 8/15/2024

    • BlueCross BlueShield SC Blue Essentials (ACA/Health Exchange)

    • BlueChoice HealthPlan SC Blue Option (ACA/Health Exchange)

    • BlueChoice HealthPlan SC (commercial lines-HMO & PPO)

    • Medicare Advantage PPO

    • Healthy Blue network

    • DeHumana Healthy Horizons (SC)

    • HumanaChoice H5216-142 (PPO)

    • HumanaChoice H5216-154 (PPO)

    • HumanaChoice H5216-157 (PPO)

    • Humana USAA Honor (PPO)

    • Humana Together in Health (PPO I-SNP)

    • HumanaChoice - Diabetes and Heart (PPO C-SNP)

    • HumanaChoice SNP-DE H5216-277 (PPO D-SNP)

    • HumanaChoice H5216-279 (PPO)

    • HumanaChoice H5216-280 (PPO)

    • HumanaChoice H5216-345 (PPO)

    • HumanaChoice H5216-346 (PPO)

    • HumanaChoice H5216-347 (PPO)

    • HumanaChoice H5525-024 (PPO)

    • HumanaChoice R3392-001 (Regional PPO)

    • HumanaChoice R3392-002 (Regional PPO)

    • HumanaChoice R3392-004 (Regional PPO)

    • Humana Gold Choice H8145-069 (PFFS)

    • Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP)

    • Humana Gold Plus H5619-083 (HMO)

    • Humana Gold Plus H5619-152 (HMO)

    • Humana Gold Plus - Diabetes and Heart (HMO C-SNP)

    • Networks

    • Medicare PPO/Employer PPO Plus

    • Medicare PPO

    • HumanaGoldChoice Ntwk PFFS

    • Natl Medicare HMO/SNP-Travel

    • National Employer HMO-Home

    • Natl Med HMO H1036 (NC)-Home

    • Natl Med HMO H5619 (SC)-Home

    • Natl Med HMO H6622 (VA)-Home

    • Natl Med HMO H6622 (NC)-Homescription text goes here

  • Medicare of North Carolina

    Medicare of South Carolina

  • Employer Individual:

    • Choice EPO

    • Choice Plus HMO

    • Choice Plus POS

    • ER Wrap 

    • Heritage HMO

    • Heritage Plus POS, Heritage Primary Advantage & Heritage

    • NATIONAL ANCILLARY

    • NexusACO NR EPO

    • NexusACO NR HMO

    • NexusACO NP POS

    • NexusACO OA POS

    • NexusACO R EPO

    • NexusACO R HMO

    • NexusACO R POS

    • NexusACO OA EPO

    • NexusACO OA HMO

    PPO

    • Select EPO 

    • Select Plus HMO

    • Select Plus POS

    • UHC DOCTORS PLAN EPO

    • UHC DOCTORS PLAN PLUS HMO

    • UHC DOCTORS PLAN PLUS POS

    • Community State Product: 

    • (NC) UnitedHealthcare Dual Complete (HMO SNR)

    • Medicare Retirement Product: 

    • AARP Medicare Advantage from UHC SC-0002 PPO

    • AARP Medicare Advantage from UHC SC-0003 PPO

    • AARP Medicare Advantage from UHC SC-0004 PPO

    • AARP Medicare Advantage from UHC SC-0005 PPO

    • AARP Medicare Advantage from UHC SC-0006 HM-POS

    • AARP Medicare Advantage Patriot No Rx SC-MAO1 (HMO-POS)

    • UHC Care Advantage SC-E001 (PPO I-SNP)

    • UHC Complete Care GS-0002 (Regional PPO C-SNR)

    • UHC Complete Care GS-001A (Regional PPO C-SNR)

    • UHC Complete Care SC-0001 (PPO C-SNP)

    • UHC Dual Complete SC-S001 (PPO D-SNP)

    • UHC Dual Complete SC-V001 (PPO D-SNP)

    • UHC Medicare Advantage GS-0001 (Regional PPO)

    • UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO)

    • UHC Nursing Home Plan SC-F001 (PPO I-SNP)

    • UnitedHealthcare Group Medicare Advantage (PPO)

    • Medicaid of NC

Vision Insurance

  • Choice EPO

    Choice Plus HMO

    Choice Plus POS

    ER Wrap 

    Heritage Plus POS, Heritage Primary Advantage & Heritage

    NATIONAL ANCILLARY

    NexusACO NR EPO

    NexusACO NR HMO

    NexusACO NP POS

    NexusACO OA POS

    NexusACO R EPO

    NexusACO R HMO

    NexusACO R POS

    NexusACO OA EPO

    NexusACO OA HMO

    PPO

    Select EPO 

    Select Plus HMO

    Select Plus POS

    UHC DOCTORS PLAN EPO

    UHC DOCTORS PLAN PLUS HMO

    UHC DOCTORS PLAN PLUS POS

Medical vs. Vision Insurance

At Poole Eyecare, we understand that navigating insurance options can be confusing. To help you make informed decisions about your eye care, here’s a clear explanation of the differences between medical and vision insurance, and how it affects your visit to our office.

Vision Insurance:

Vision insurance primarily covers routine eye care and preventive services, including:

  • Annual eye exams

  • Prescription glasses and contact lenses

  • Discounts on frames and lenses

Vision insurance is typically used for regular check-ups to ensure your eyes are healthy and to update your prescription for glasses or contact lenses.

Medical Insurance:

Medical insurance covers eye care related to medical conditions, diseases, and injuries. This includes:

  • Treatment for eye infections or injuries

  • Management of chronic conditions like glaucoma or diabetic retinopathy

  • Medical procedures and surgeries related to eye health

Medical insurance is used when you have a specific eye health issue that requires medical attention beyond a routine vision exam.

Can I use both insurances at my appointment?

Due to insurance regulations, you cannot use both your vision and medical insurance on the same day for different services. If you require both a medical eye exam and a routine vision exam, you have two options:

1. Schedule your medical exam and routine vision exam on different days to use the appropriate insurance for each visit.

2. Pay the cash price for the refraction part of your visit if you wish to have both exams on the same day.

We strive to provide you with the best care while ensuring your visit aligns with insurance policies. Please contact our office if you have any questions or need assistance with scheduling your appointments.