How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for an eye problem, a check on an eye condition or a follow-up is billed to medical insurance. Many visits mix the two, and the front desk explains which part goes where. Medicare does not cover routine eye exams or glasses, with a few narrow exceptions.
Vision plans, for routine exams, frames, lenses and contact lenses
Medical plans, for eye health visits and follow-ups
Medicare, within its limits for eye care
If you pay yourself
Paying yourself covers the exam and each thing you order: frames, lenses, coatings, contact lenses, repairs and replacement lenses. The optician tells you what each part costs before you decide, and we never treat a price quoted on the phone as a promise.
The exam
Frames and lenses
Repairs and replacement lenses
Receipts for reimbursement
Ask for an itemized receipt and send it to your plan. The plan decides what it pays back.
An estimate in advance
If you pay without insurance, we give you a written estimate before your visit or your order. If a bill comes to $400 or more above your estimate, you can dispute it.
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 eye exam takes about 45 minutes and covers your prescription and the health of your eyes. A first fitting takes about 30 minutes. Each 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 at an optical shop. Your plan decides what it pays, and we check before you come.
| Visit or product | Vision plan | Medical insurance | You pay |
|---|---|---|---|
| Routine yearly eye exam | Vision planUsually | Medical insuranceNot usually | You payAny copay your plan leaves |
| Eye problem or follow-up visit | Vision planNo | Medical insuranceUsually | You payCopay or deductible |
| Frames and lenses | Vision planOften, up to the eyewear benefit | Medical insuranceNo | You payAnything above the benefit |
| Contact lens exam and fitting | Vision planSometimes | Medical insuranceRarely | You payThe fitting, when a plan does not pay it |
| Repairs and adjustments | Vision planNo | Medical insuranceNo | You payQuoted at the desk before we start |
Your prescription is yours
You get a copy of your prescription after your exam and fitting, whether or not you buy anything from us. Fill it anywhere.
Questions about a bill?
Call the shop before your visit and we will go through it with you.