How fees work
Who pays for which visit, what the fitting fee covers and how you hear the amount before you begin.
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for an eye problem, a follow-up or an eye health check is billed to medical insurance, and many visits mix both. Some medical plans cover specialty lenses for certain eye conditions, often after the plan approves the fitting first. Medicare does not cover routine eye exams or glasses, with a few exceptions.
Vision plans, for routine exams and some lens allowances
Medical plans, for eye health visits and some specialty lenses
Medicare, within its limits for eye care
If you pay yourself
If you pay yourself, the exam, the fitting fee and the lenses are quoted separately. The fitting fee covers the doctor's time across the whole fitting: the maps, the trial lenses, the design changes, the handling lesson and the fit checks that belong to it. Lenses, cases and solutions are billed on their own.
The exam
The fitting fee
The lenses and supplies
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, we give you a written estimate before your first visit, and a good faith estimate on request. If a bill comes in $400 or more above that estimate, federal law lets you dispute it.
Checking your benefits
Before your first visit we check your benefits where we can and tell you what we find. Please check with your plan too, because the plan has the final say. For a specialty lens we also ask the plan whether it must approve the fitting first.
What the first visit includes
The first visit is a comprehensive exam and the maps, about 90 minutes. The exam is billed as above, and the fitting fee is agreed with you in writing before the first visit.
Which visit goes where
Vision plan, medical insurance or you
The usual pattern for the visits in a fitting. Your plan decides what it pays, and we check before you come.
| Visit or product | Medical insurance | You pay | Vision plan |
|---|---|---|---|
| Routine yearly eye exam | Medical insuranceNot usually | You payAny copay your plan leaves | Vision planUsually |
| Exam for an eye problem | Medical insuranceUsually | You payAny copay or deductible | Vision planNot usually |
| Specialty lens fitting | Medical insuranceSome plans, for certain conditions | You payThe fitting fee, in writing first | Vision planSometimes, as a lens allowance |
| Follow-up checks | Medical insuranceUsually, when the fitting is covered | You payAny copay your plan leaves | Vision planRarely |
| Lenses, cases and solutions | Medical insuranceSome plans, for certain conditions | You payWhat the plan does not pay | Vision planSometimes, within an allowance |
- Your prescription is yours. We give you a copy of your glasses and contact lens prescriptions when your exam and fitting are complete, and you can fill them anywhere.
Ask us about your plan
Call before you book and the patient coordinator will check your benefits and tell you what she finds.