How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for dry eye, another eye problem or a follow-up is billed to medical insurance, and many visits mix both. We tell you which part goes where. Medicare does not cover routine eye exams or glasses, with a few exceptions.
Vision plans, for routine exams, glasses and contact lenses
Medical plans, for dry eye evaluations, treatments and follow-ups
Medicare, within its limits for eye care
If you pay yourself
If you pay yourself, the evaluation and the care you ask for are billed to you. Treatments done in the office are often not covered by a plan, and we say so before you decide. We do not promise a price by phone, because it depends on what your tests show.
The evaluation and its tests
Treatments done in the office
Drops, 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, you can ask for a written Good Faith Estimate before your visit. If a bill comes to $400 or more above the estimate, you can dispute it.
Your rights under the No Surprises ActChecking your benefits
Before your visit our patient coordinator checks your benefits where she can and tells you what she finds. Please confirm with your plan too, because the plan has the final say.
What the first visit includes
A first dry eye evaluation takes about an hour and a quarter. It covers the tests, an eye health check and a first plan. 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 in a dry eye plan. 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 |
| Dry eye evaluation and follow-ups | Medical insuranceOften, as an eye health visit | You payCopay or deductible | Vision planRarely |
| Eye problem or urgent visit | Medical insuranceUsually | You payCopay or deductible | Vision planNo |
| Glasses and contact lenses | Medical insuranceNo | You payAnything above the benefit | Vision planOften, up to the eyewear benefit |
| Treatments in the office | Medical insuranceSometimes | You payOften, with a written estimate | Vision planRarely |
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 office before your visit and our patient coordinator will go through it with you.