How fees work
Who pays for which part of a fitting, and how you hear about it before you do.
Insurance we work with
A routine eye exam or a lens fitting for glasses-free vision is billed to a vision plan where the plan covers it. A visit for a medical eye problem, a corneal condition or a follow-up is billed to medical insurance, and many fittings for these conditions are. Many visits mix both, and the office explains which part goes where. Medicare does not cover routine eye exams or glasses, with a few exceptions.
Vision plans, for routine exams and for lenses a plan covers
Medical insurance, for corneal conditions and their follow-up
Medicare, within its limits for eye care
If you pay yourself
Self-pay covers the exam and the services you ask for. Measurements, trial lenses, the lenses themselves, handling lessons and follow-up visits are itemized, and lenses made to order are billed separately from the visits. We don't promise a price over the phone, because the fit decides what the lenses need.
The exam and measurements
Fitting and follow-up visits
Custom lenses and lens care
Receipts for reimbursement
Ask for an itemized receipt and send it to your plan. The plan decides what it reimburses, and we can describe each line in plain words if your plan asks.
An estimate in advance
If you pay without insurance, we give you a written Good Faith Estimate before your visit. If a bill comes to $400 or more above that estimate, you have the right to dispute it. Ask when you book.
Checking your benefits
Before your first 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 on what it pays.
What the first visit includes
The measurement visit takes about 90 minutes. It covers a review of your records, measurements of the front of each eye, an eye health check and a first trial fitting. The exam is billed as above, and anything you pay yourself is agreed in writing first.
Who pays
A vision plan, medical insurance or you
Part of a fitting is routine, part is medical. We tell you which is which before you pay.
| Visit | Vision plan | Medical insurance | You pay |
|---|---|---|---|
| A routine exam | Vision planUsually | Medical insuranceNot usually | You payWhat the plan doesn't cover |
| A visit for a corneal condition | Vision planNot usually | Medical insuranceUsually | You payYour plan's share, such as a copay or deductible |
| A fitting for a medical reason | Vision planSometimes | Medical insuranceOften | You payWhat neither covers |
| Lenses and lens care | Vision planSometimes, within the plan's limit | Medical insuranceSometimes | You payWhat the plan leaves |
| Follow-up checks | Vision planRarely | Medical insuranceOften | You payYour plan's share |
Your prescription is yours
Your prescription is yours. We give you a copy after your exam and fitting, and you can fill it anywhere. The prescription isn't held back until you pay for lenses or glasses.
Plans differ, and a plan has the final say on what it pays. If something on a bill doesn't look right, call the office and we'll go through it line by line.
Questions about a bill?
Call the office and we'll go through it with you.