Which plan pays
Which plan pays for which visit
The usual pattern. Your plan decides what it pays, so we check your benefits before the visit and tell you what we find.
| The visit | Vision plan | Medical insurance | You pay |
|---|---|---|---|
| Routine yearly eye exam | Vision planUsually | Medical insuranceNot usually | You payAny part your plan leaves |
| Glasses and contact lens fitting | Vision planOften, within the plan's allowance | Medical insuranceNo | You payThe rest, after a written estimate |
| Diabetic eye exam | Vision planNot usually | Medical insuranceOften | You payYour copay or deductible |
| Glaucoma monitoring | Vision planNo | Medical insuranceUsually | You payYour copay or deductible |
| Red eye, infection or an eye injury | Vision planNo | Medical insuranceUsually | You payYour copay or deductible |
| Dry eye evaluation | Vision planSometimes, for the routine part | Medical insuranceOften, as a medical visit | You payTreatments a plan does not cover |
| A visit that is part routine and part medical | Vision planThe routine part | Medical insuranceThe medical part | You payWhat is left over |
When one visit is both
We tell you before
At check-in, the office explains which part of your visit is routine and which is medical.
We bill each part where it belongs
The exam for glasses to your vision plan, and the eye health work to medical insurance.
You get an itemized receipt
For any part you pay yourself or send to a plan that reimburses you.
Medicare and Medicaid
Medicare
Medicare does not cover routine eye exams or glasses, with narrow exceptions. It covers some medical eye visits, within its limits.
Medicaid
Coverage for adults depends on the plan. Call us, and we will check yours before the visit.
Questions about a bill?
Call the office before your visit, and we will go through it with you.