Our Insurance & Payment Policies

In most cases, medical insurance will cover a portion of the cost of ocular prosthetic services. However, there are usually some out-of-pocket costs that is the patients responsibility. Patients are responsible for any and all uncovered amounts once a medical claim has been processed. Our services do not fall under vision benefits. 

Jahrling Ocular Prosthetics, Inc. is contracted (in-network) with the following insurances:

- Aetna

- Blue Cross Blue Shield of Massachusetts

- Harvard Pilgrim Health Plan

- Health Plans, Inc.

- MassHealth (Standard plans only)

- Wellpoint (previously called Unicare and GIC)

Please contact our office directly with questions regarding your insurance coverage. If your insurance is not listed here, it does not necessarily mean we cannot bill your insurance. 

The insurances in which we are out of network with typically require prior authorization in order to be covered at the in-network level. All prior authorizations require current MD notes, referring the patient to us for continued artificial eye services. 

All insurances require a letter of medical necessity/prescription/detailed written order from a medical doctor for an ocular prosthesis to be fabricated and fit, as well as for the patient to receive ongoing artificial eye services. 

DEDUCTIBLE: A deductible is the amount you pay for covered healthcare services before your insurance plans starts to pay. With a $2,000 deductible for example, you pay the first $2,000 of covered services yourself. 

COINSURANCE: The percentage of a covered healthcare service you pay (20%, for example) after you've met your deductible. 

Let's say your health insurance plan's allowed amount for an office visit is $85, and your coinsurance is 20%:

- If you've met your deductible: You pay 20% of $85, or $17. The insurance company pays the rest.

- If you haven't met your deductible: You pay the full allowed amount, $85.

COPAY: A fixed amount ($20, for example) you pay for a covered healthcare service after you've met your deductible. 

Let's say your health insurance plan's allowable cost for an office visit is $85, and your copayment is $20.

- If you've met your deductible: You pay $20.

- If you haven't met your deductible: You pay $85, the full amount for the visit.