How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for a dry eye problem, for a check of the eyelid glands or for a follow-up is billed to medical insurance, because the eye is being treated as a medical concern. Many visits mix both, and the office explains which part goes where. Medicare does not cover routine eye exams or glasses, with narrow exceptions.
Vision plans, for routine exams, glasses and contact lenses
Medical plans, for dry eye evaluations and follow-ups
Medicare, within its limits for eye care
If you pay yourself
Self-pay covers the visit and the tests the doctor orders. Some in-office treatments, fitting fees, premium lenses and replacement lenses are billed separately, and a plan may not cover them. We do not promise a price over the phone. We tell you what each part costs before you decide.
The evaluation and its tests
In-office treatments
Lenses, fittings and follow-ups
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 good faith estimate in writing before your visit. If a bill is $400 or more above that estimate, you can dispute it. Ask for the estimate when you book.
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
The first visit is a dry eye evaluation with a set of tests, an eye health check and a talk about what the results mean. It takes about an hour. It is billed as above, and anything you pay yourself is agreed in writing first.
Which plan pays
Vision plan, medical insurance or you
| Visit | Billed to | Examples | Good to know |
|---|---|---|---|
| A routine eye exam | Billed toA vision plan | ExamplesA yearly exam, a new glasses prescription, a contact lens fitting. | Good to knowCoverage differs by plan. We check before the visit. |
| A dry eye evaluation or follow-up | Billed toMedical insurance | ExamplesThe tear film and eyelid tests, and the return visits. | Good to knowBilled as a medical visit. Your plan may apply a deductible. |
| A treatment or lens option a plan does not cover | Billed toYou | ExamplesSome in-office treatments, premium lenses and replacement lenses. | Good to knowAgreed with you in writing before it is done. |
Your prescription is yours
We give you a copy of your glasses prescription after your exam, and a copy of your contact lens prescription when your fitting is done. You do not need to buy from us, and you can fill it anywhere.
Questions about a bill?
The billing desk can explain a visit before it happens.