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INSURANCE INFORMATION

As of January 1, 2025 we will no longer take Medicare Advantage plans.

At Eye Care Associates of Sarasota, our patients are at the center of everything we do and your trust is very important to us. Sharing information is one way that ensures we continue to be  trusted partners for your eye health needs. We want to inform you of some changes that will be taking place and the reasons behind these changes.

As of January 1, 2025 we will no longer take Medicare Advantage plans of any kind. We will continue to accept  Traditional Medicare with or without a secondary plan. Because you are an established patient, we will continue to accept your present plan for 2024.

Many retirees who enroll in a Medicare Advantage plan do so for the low-cost premiums and “extra benefits” they are promised. A sizable percentage of those retirees do not understand that they are signing over their Medicare benefits for Parts A & B to a private insurance company. 

Medicare advantage plans are not Medicare. These are private insurance companies who are paid a set amount by Centers for Medicare Services for each patient they enroll. The more people these private insurers sign up the more money they make from Medicare. Unfortunately, these companies do not pay physicians the same as Medicare would. The “extra benefits” these plans promise are paid for with additional co-insurance charges or denials for other care.

Over the past 2 years there has been an explosion of Medicare replacement plans, each one has its own rules and regulations. Some of these plans are regional, which means we could be out of network, others are hidden HMO’s and need prior authorizations and/or referrals. We can no longer keep up with the administrative burden that all these plans cause.

We are sorry for any inconvenience these changes may cause you. We appreciate your faith and trust in us and thank you for the opportunity to serve your healthcare needs.

 Please understand that it is YOUR responsibility to know how YOUR plan works, ie: if you need authorization or have out of network benefits, etc.


Medicare




We DO participate in Regular Medicare.

         
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Medicaid and Veteran's

Medicaid Plans

Full Medicaid w/ Gold card
Medically Needy/Share of Cost

We are out of network with Staywell, Prestige, Sunshine and Molina HMO’s, Freedom Health Dual and Optum
Veteran’s Services

Healthnet Federal Services =Need Authorization
Tricare For Life

Medicare Advantage and Private Plans

                         ALL HMO Plans
          need authorization from your PCP 
We are out of network with  ALL CIGNA  Plans and UMR

We are out of network for ​​​​​​​Aetna Medicare HMO- We can no longer accept any MEDICARE ADVANTAGE PLANS as of 1/1/2025
Aetna Medicare Advantage Plans                           
Aetna Essentials Plan PPO                         
Aetna Medicare Choice Plan PPO                 
Aetna Medicare Connect Plus PPO             
Aetna Medicare Elite Plan PPO                       
Aetna Medicare Freedom Plan PPO               
Aetna Medicare Gold Plan PPO
Aetna Medicare Innovation Choice Plan PPO   
Aetna Medicare Platinum Plan PPO                   
Aetna Medicare Plus Plan PPO                         
Aetna Medicare Select Plan PPO                       
Aetna Medicare Standard Plan PPO                 
Aetna Medicare Value Plan PPO                         
Aetna Medicare SM PPO                                     
Aetna Premier Plan PPO                                     
   Aetna Marketplace Plans    THESE NEED AUTHORIZATION FROM YOUR PCP                             
Silver CoPay Savings Plus HMO
 Bronze CoPay Savings Plus HMO
Bronze HSA Savings Plus HMO
 Catasrophic Savings Plus HMO
Gold CoPay Savings Plus HMO
Silver CoPay Savings Plus HMO
 Aetna Private Plans
Bronze Ded Only HSA MC PD
 Aetna Classic 3500 PD
Silver CoPay 2950 Savings HMO
 Bronze CoPay Savings Plus HMO
Bronze HAS Savings Plus HMO 
Catastrophic Savings Plus HMO
Catastrophic MC PD Gold Savings Plus HMO
We are out of network with UHC Charter and
 Charter Balanced Plans as well as Medicare Advantage plans (as of 1/1/2025)
 UHC Medicare Advantage Plans                                                            
AARP Medicare Complete HMO                                     
AARP Medicare Complete Choice Plan 2 Reg PPO         
AARP Medicare Complete Choice Essential Reg PPO    
UHC Dual Complete RP One Reg PPO SNP                   
UHC Dual Complete LP HMO SNP                               
UHC Nursing Home Plan PPO SNP                               
UHC Assisted Living Plan PPO                                                                                                
UHC Private Plans                                    
Navigate and HMO
Medica Choice wUHC Choice Plus 
UHC Choicee and Choice HMO                   
Navigate Plus and Plus HMO
Navigate Balanced and HMO
UHC Choice Plus Harvard Pilgrim 
 UHC Core   
UHC Heritage Plus
UHC Heritage Select POS/HMO/EPO
UHC Heritage Select Advantage
UHC Options and Options PPO
UHC Options PPO w/ Harvard Pilgrim
 Passport Connect Options PPO
Passport Connect Choice /Choice Plus
 UHC Select and HMO
UHC Select Plus                                                             
We are out of network  Blue Cross/Blue Shield HMO’s, 
Anthem BCBS Private and Blue Select Marketplace Plan.  We will not accept Medicare Advantage plans after 1/1/2025
BC/BS Medicare Advantage Plans
Blue Medicare PPO and Group PPO                               
Blue Choice Blue Medicare Regional PPO              
 BCBS Private Plans 
Bllue Card PPO and EPO
 Blue Options Traditional
​​​​​​​Blue Card Traditional
BCBS FEP (Federal)
BC Preferred Patient Care Temp Ins Protection 
We are out of network for Humana Gold Plus HMO. We will not be accepting Medicare Advantage Plans after 1/1/2025
Humana Medicare Advantage Plans 
Humana Medicare                                                             
Medicare Network PFFS Plan                                                              
Humana Dual Complete
Humana Private Plans
Humana PPO / POS / EPO/ HMO
Humana Traditional​​​​​​​
OTHER PLANS
WebTPA  -
needs authorization after 3 visits to same KIND of specialist
Manatee Health “Your Choice”
(Aetna Open Access Network)
Healthsmart Accel 
Healthsmart Preferred,
Healthsmart Payors Org-HPO
MultiPlan- May need Aurhorization
Multiplan Complimentary
Multiplan Limited Benefit Plan
Integrated Health Plans-Now Multi Plan 
 We are out of network for Multiplan PPO, Multiplan Value Point plan,
 Multiplan Health EOS, Beech Street
PHCS
PHCS for practitioners
PHCS Healthy Directions
PHCS Savility PHCS Specific Services Plan
AV-Med JHS-Elite (may need auth) Av-Med MDC Elite (may need auth)
 We are out of network with Av-Med Choice, Empower Plans, Engage Plans, all other Av-Med plans
We do not participate in Equian Provider Network, Advantica, Optimum or Freedom Healthcare

           
      


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