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, and so are most imaging tests that go with it. Many visits mix both, and we explain which part goes where. Medicare does not cover routine eye exams or glasses, with a few exceptions.
Vision plans, for routine exams and glasses
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 the tests you ask for. Imaging, fittings, premium lens options and replacement lenses are billed separately. We tell you what each part costs before you decide, and we do not quote a price on the phone as a promise.
The exam
Imaging and tests
Lenses and coatings
Receipts for reimbursement
Ask for an itemized receipt and send it to your plan. The plan decides what it reimburses.
An estimate in advance
If you pay without insurance, you have the right to receive a Good Faith Estimate of what your care will cost before you start, and we give you one in writing. If a bill is $400 or more above the estimate, you can dispute it. The estimate is not a contract.
Checking your benefits
Before your visit we check your benefits where we can and tell you what we find. Please confirm with your plan too, because the plan has the final say.
What the first visit includes
A first visit takes about an hour and a quarter. It covers your history, your vision, eye pressure, a dilated exam and imaging when it helps. The visit 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 for the visits here. Your plan decides what it pays, and we check before you come.
| The visit | Vision plan | Medical insurance | You |
|---|---|---|---|
| A routine yearly exam | Vision planUsually | Medical insuranceNot usually | YouAny copay your plan leaves |
| A visit for an eye problem or a follow-up | Vision planNo | Medical insuranceUsually | YouCopay or deductible |
| A diabetic eye exam | Vision planSometimes, for the routine part | Medical insuranceOften, with imaging | YouCopay or deductible |
| Glaucoma visits, tests and imaging | Vision planNo | Medical insuranceUsually | YouCopay or deductible |
| Glasses and contact lenses | Vision planOften, up to the eyewear benefit | Medical insuranceNo | YouAnything above the benefit |
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 the main office before your visit and we go through it with you.