Aetna
- Commercial
- Medicare PPO
- Medicare HMO
Coverage
Insurance information
What to check before your visit, how billing works, and the plans we commonly accept.
Before you visit
Please confirm these
- Referrals If your plan requires a referral to see an ophthalmologist, get it from your Primary Care Physician before your visit.
-
Routine exams
If you qualify for a periodic routine eye exam, call your insurer first to confirm you are still eligible and have not used your benefit already — some plans limit these exams.
Note: Medicare does not pay for routine eye exams.
Billing
Co-pay, deductibles, co-insurance
Co-payments are due in full at the time of your visit. We accept major credit cards, cash, and checks.
Plans increasingly pass costs to patients through co-insurance, deductibles, and similar fees. You may owe out-of-pocket amounts even with insurance. Statements are mailed to you and paid directly to the Eye Center.
Critical
Billing disclaimer — read before you visit
A plan listed on this page — or someone telling you we “accept” a plan — does not mean your insurer will pay the claim in full.
You are responsible for confirming that the insurance plan you buy or are enrolled in considers our doctors in-network for the Framingham office. We are not responsible for validating every detail of your plan participation, because we are not privy to all of those details.
Our insurance checks are basic and do not cover the nuances of today’s plans. Insurers can also decide retroactively that you were not covered and treat you as liable for payment to us. That is uncommon, but it happens — confirm clearly with your insurer what is and is not covered before your appointment.
Plans · 2026
Insurance plans we accept
We and insurers both change participation without much notice. If your plan isn’t listed, call us — then verify with your insurer that the doctor you want is in-network for Framingham.
All HMO plans require referrals. marks plans that we know need a referral.
Blue Cross Blue Shield
- Anthem
- Federal
- HMOR
- Medex
- Medex ChoiceR
- Medicare Advantage HMOR
- Medicare Advantage PPO
- New England HMOR
- PPO
Cigna
- No referral needed
Fallon
- EyeMed
- Community Care
-
Navicare HMOR
- Referral required, even for routine visits
- Fallon Medicare Plus HMOR
Harvard Pilgrim
- HMOR
- Medicare Enhance
- Medicare Supplement
- PPO
- POSR
Humana
- Accepted as secondary coverage only
Mass General Brigham Health Plan
-
Commercial plans
- Complete
-
HMOR
- Referral required, even for routine visits
- PPO
Tufts
- EyeMed
- Direct
- HMOR
- Medicare Preferred HMOR
- Medicare Preferred PPO
- Navigator (GIC)R
- PPO, EPO, POS
- SeniorR
- Tufts Medicare Complement
- Tufts Medicare Supplement
UMR / Wausau
- No referral required
UnitedHealthcare
- Spectera
- Senior Care Options
- Medicare Advantage HMO (AARP)R
- Medicare Advantage PPO (AARP)
Wellpoint
- No referral needed
Vision plans
- EyeMed
- Spectera
Not accepted
Insurances we do not accept
These plans are not accepted at the Eye Center. Please call if you are unsure about your coverage.
- BIDCO
- BMC
- Community Care Alliance
- First Health
- Humana Direct Choice
- Johnson & Johnson Select
- All MassHealth plans
- Superior
- Wellcare
- Wellforce
- Wellsense
Fallon
- Fallon 365
- Direct
- Freedom
- Select
- Senior Medicare
- Fallon Steward
Mass General Brigham Health Plan
-
ACO (MassHealth)
- Allies
- One Care
- Select
- Limited
- Medicare Advantage
- Value
Tufts
- Net Health
- Together
- Spirit
- Tufts Health One Care (MassHealth)
UnitedHealthcare
- Senior Whole Health (MassHealth)
Vision plans
- Blue Cross Vision (Blue 20/20)
- EyeMed Insight
- Davis
- March Vision
- TJX Vision
- VSP / MetLife / Guardian