Services
How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit for an eye problem, an eye disease check or a follow-up is billed to medical insurance, and many visits mix both. We tell you which part goes where. We work with many vision plans, so call to confirm yours. Medicare does not cover routine eye exams or glasses, with a few narrow exceptions.
Vision plans, for routine exams and eyewear
Medical plans, for eye health visits and follow-ups
Medicare, within its limits for eye care
If you pay yourself
Self-pay covers the exam and anything you ask us to do. Frames, lenses, coatings, contact lens fittings and replacement lenses are billed separately, and each is explained before you decide. Every prescription is different, so we don't quote a price by phone as a promise.
The eye exam
Frames and lenses
Contact lens fitting and follow-up visits
Receipts for reimbursement
Ask for an itemized receipt and send it to your plan. Your plan decides what it reimburses, and we are glad to explain what is on it.
An estimate in advance
If you pay without insurance, we give you a Good Faith Estimate in writing before your visit. If your bill comes to $400 or more above that estimate, you can dispute it. Eyewear is priced in writing before you order.
Checking your benefits
Before your visit we check your vision and medical 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 an hour with one of our optometrists and is billed as above. If you choose glasses, Carmela goes through frames and lenses with you and writes down the cost of each choice before anything is ordered.
Which visit goes where
Vision plan, medical insurance or you
The usual pattern for the visits and products 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 |
|---|---|---|---|
| A routine yearly eye exam | Vision planUsually | Medical insuranceNot usually | You payAny copay your plan leaves |
| A visit for an eye problem or a follow-up | Vision planNot usually | Medical insuranceUsually | You payCopay or deductible |
| Glasses and contact lenses | Vision planOften, up to your eyewear benefit | Medical insuranceNo | You payAnything above the benefit |
| Lens extras and coatings | Vision planSometimes, in part | Medical insuranceNo | You payUsually, written down first |
| Contact lens fitting | Vision planSometimes, in part | Medical insuranceRarely | You payUsually, explained first |
Your prescription is yours
Your prescription is yours. We give you a copy after your exam and fitting, whether or not you buy anything from us, and you can fill it at any shop or website you like. If you want help reading it, ask Carmela or one of our doctors.
Questions about a bill?
Call the shop before your visit and we will go through it with you.