How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for an eye problem, an eye disease check or a follow-up is billed to medical insurance. Many visits mix both, and we explain which part goes where. Medicare does not cover routine eye exams or glasses, with a few exceptions. Call us with your plan and we will tell you what we can.
Vision plans, for routine exams, glasses and contact lenses
Medical insurance, for eye health visits and follow-ups
Medicare, within its limits for eye care
If you pay yourself
Self-pay covers the exam and whatever you choose to add. Contact lens fittings, premium lens options and replacement lenses are billed separately. We do not quote a price over the phone as a promise, and we tell you what each part costs before you decide.
The exam
Contact lens fittings and follow-ups
Frames, lenses and coatings
Receipts for reimbursement
Ask for an itemized receipt, and send it to your plan. The plan decides what it pays back.
An estimate in advance
If you pay without insurance, we give you a written Good Faith Estimate before your visit. Ask when you book. If a final bill is $400 or more above your estimate, you have the right to dispute it.
Checking your benefits
Before your visit we check your benefits where we can and tell you what we find. Please confirm with your plan as well, because the plan has the final say.
What the first visit includes
A full eye exam takes about an hour. A contact lens fitting adds a little more time. The exam is billed as above, and anything you pay yourself is agreed in writing first.
Which visit goes where
Vision plan, medical insurance or you
The usual pattern. Your plan decides what it pays, and we check before you come.
| Visit or product | Vision plan | Medical insurance | You pay |
|---|---|---|---|
| Routine yearly eye exam | Vision planUsually | Medical insuranceNot usually | You payAny copay your plan leaves |
| Eye problem, eye disease check or follow-up | Vision planNo | Medical insuranceUsually | You payCopay or deductible |
| Glasses | Vision planOften, up to the plan's eyewear benefit | Medical insuranceNo | You payAnything above the benefit |
| Contact lens exam and fitting | Vision planSometimes | Medical insuranceRarely | You payThe fitting, if the plan does not cover it |
| Repairs and adjustments | Vision planNo | Medical insuranceNo | You payTold to you before work starts |
Your prescription is yours
Your prescription is yours. We give you a copy after your exam and fitting, and you can fill it anywhere.
Questions about a bill?
Call either door before your visit and we will go through it with you.