Insurance
Understanding Your Coverage
Knowing your health insurance coverage is part of being an educated consumer of health care services.
Health insurance is a contract between you and your insurance plan and many plans have co-pays and high deductibles.
While we work with insurance plans on your behalf, any charge not paid by your insurance is your responsibility.
“Medical” vs. “Routine” coverage
Most insurance plans cover an exam for a medical reason, ie., a specific eye problem. Unfortunately, not all insurances cover an examination where there is no medical eye problem and no symptoms except for a change in vision that can be corrected by eyeglasses.
Some insurance plans cover this type of “routine” eye exam but limit the frequency to one examination every 12 or 24 months. Please check with your insurance to know if your exam will be covered.
Vision Plans
Such as EyeMed or VSP provide periodic coverage for “routine” eye care. Our optometrists are providers for most but not all vision plans.
Physician Referrals
If your insurance requires a referral from your primary care physician, you need to obtain it before your visit. If you do not have a valid referral for your visit, we will reschedule your appointment to a later date.
Medicare does not require referrals but some replacement and supplemental plans do.
Refraction
This is a visual testing process to determine your best-corrected vision and results in the issuance of a prescription for your glasses. For Medicare-covered patients, refraction is an excluded benefit.
The fee for this service is due at the time of your appointment. Please let our technicians know if you prefer not to have your glasses prescription updated.
Dilated Eye Examination
As part of your eye exam, your eyes may be dilated to allow the doctor to evaluate the health of your retina (the back of your eye). This will cause your vision to blur slightly and your eyes will be light-sensitive for a few hours following your visit.
Please ask one of our technicians if you would like temporary sunglasses to reduce the glare of light. For most patients, the effect of dilation resolves within 3-5 hours.
Appointment Cancellations
If you need to reschedule your appointment, please contact the office no later than 24 hours prior to your scheduled appointment.
Office Visit Summary and Patient Portal
Following your appointment, you will receive an email invitation to obtain a visit summary through our Patient Portal.
Please provide us with your email address or an email address of an individual participating in your care. By establishing a username and password you will be able to receive and request information related to your care.
Contact Lens Services
Contact lens services are provided by our Optometrists. If you wear contacts, please wear them to your appointment and bring in the related packaging so that our Optometrists can readily identify what lens you are wearing.
If your insurance covers your eye exam but not your contact lens update, the cost of the update is your responsibility. You will need to have a comprehensive eye exam within a year to have your contact lens script updated.
New Contact Lens Wearers
Our Optometrist will evaluate the health of your eyes before fitting you with a contact lens. After your exam, you will have a contact lens fitting.
This is a 45-minute appointment to determine the best choice of lens and to train you in the insertion and removal of contacts.
The cost of a contact lens fitting ranges from $125 to $200 depending on the complexity of the fit and the number of follow-up appointments needed.
A contact lens fitting for a keratoconus condition may be covered by insurance. Contact lens services not covered by insurance are payable at the time of service.
