Insurance at Khanna Vision Institute

Vision insurance and medical insurance

Vision insurance usually covers glasses and contact lenses. It usually does not cover surgery.

Medical insurance is separate. It can apply to cataract surgery when the surgery is a medical service under your plan. Bring both cards to your visit if you have them. We will tell you which one, if either, applies to the care you are considering.

If a procedure is not an insurance benefit, you can review financing options separately from insurance.

HMO and PPO

An HMO (health maintenance organization) generally expects you to use doctors in its network. You often need a referral from a primary doctor before you see a specialist, and care outside that network may not be paid.

A PPO (preferred provider organization) generally lets you see a specialist without a referral. You can usually also see a doctor outside the network, though your share of the cost is often higher than for an in-network doctor.

Khanna Vision Institute accepts PPO plans only. We do not accept HMO plans. If your medical plan is an HMO, we cannot bill that plan. Call the office before you schedule if you are not sure which type of plan you have.

We do not accept Medi-Cal. That does not mean we refuse medical insurance. A PPO medical plan can still apply to care such as cataract surgery when the plan covers it.

Copay and deductible

Copay

A copay is a set dollar amount you pay for a covered visit or service. The amount is set by your plan, not by our office. You may owe a copay at a visit even when the rest of the service is billed to insurance.

Deductible

A deductible is the amount you pay for covered care before the plan starts paying its share. If you have not met the deductible for the year, more of a cataract surgery bill can fall to you. After the deductible is met, the plan pays according to its rules, and you may still owe a copay for some services.

Cataract surgery coverage

Medical insurance can apply to cataract surgery. What it pays depends on your plan, whether the deductible is met, and whether the plan treats the service as covered. We do not quote plan payments on this page. Our staff can check benefits for a PPO plan and explain what your plan reports back.

Some glaucoma treatments can be discussed at the same time as cataract surgery. Two you may hear about are iStent and iDose. They are not the same as the cataract removal itself, and a plan can cover one service and not another.

iStent

An iStent is a very small implant that can be placed during cataract surgery to help lower eye pressure in glaucoma. Whether medical insurance pays for an iStent depends on your plan and on medical necessity. Ask us to check that benefit before surgery if an iStent is part of the plan we recommend.

iDose

iDose is an implant that releases glaucoma medication inside the eye. It is sometimes considered along with cataract surgery. Coverage is specific to your medical plan. A benefit check tells us whether the plan expects to pay for it or whether you would be responsible.

ABN

ABN means Advance Beneficiary Notice of Noncoverage. It is a Medicare notice. You may be asked to sign an ABN before a service that Medicare may not cover, including a cataract-related item such as a lens choice, an iStent, or iDose when Medicare is not expected to pay. The form tells you that you may have to pay for that service yourself. It is a notice so you can decide. It is not a bill, and it does not change what a PPO or other plan has already agreed to cover.

Lens choices are a separate conversation from insurance. See which lens is right for how those options differ, and what to expect for cataract surgery for the visit itself.

Offices

Consultations are at our Beverly Hills and Westlake Village offices. Cataract procedures are done at the surgery center at 9001 Wilshire Blvd, Suite 100, not at those offices.