Prosthetic eyes and related services are a covered procedure under Medicare. Prior to your fitting, a request from your ophthalmologist is required. This request can be in the form of a written prescription from your ophthalmologist or a letter requesting this service.
After meeting your annual deductible, Medicare pays 80% of their allowed amount. If you have a supplemental insurance, they should pay the remaining 20%. We accept Medicare assignment, therefore, payment is not due at the time of service.
Medicare Replacement Plans:
You will need to go through your Primary Care Provider (PCP) to receive an out-of-network authorization to our office. If your doctor's office requires assistance in getting this authorization for you, please have them call our office.
Texas Medicaid covers patients aged 20 and under for prosthetic eyes and related services. Each type of Medicaid (Traditional and Medicaid Replacement) requires prior authorization.
We are contracted with the Dallas area VA. If your VA doctor has referred you to us, please make sure to contact the VA Prosthetic Department at 214 857-0548 for prior authorization before making an appointment with this office.
Most insurances will pay at least a portion of our fee. Since Dallas Eye Prosthetics is NOT a provider with any HMO, PPO, or POS, it is the patient's responsibility to get the required information to our staff for research of benefits prior to your appointment. Our staff is always available to help with regard to insurance questions. Since we are not providers with any insurance, the patient is responsible for the difference between the allowed amount of their policy and the billed charges.
We also work with a large number of support agencies such as DARS (Department of Assistive Rehabilitative Services), Crime Victims, Knights Templar and Texas Lion's Club on an individual basis. Please have your caseworker contact our office.