Insurance, Billing & Patient Process FAQs

Below are answers to some of the most common questions patients ask regarding insurance coverage, billing, and preparing for their visit. These FAQs cover vision plans vs. major medical health insurance, using HSA/FSA funds, CareCredit financing, refraction fees, and completing new patient online forms.

If you are preparing for an upcoming visit and want a complete overview of our financial and intake policies, you can learn more about our Insurance & Payment Options, including accepted plans, self-pay pricing, and online registration.

Is a diabetic eye exam or red eye visit covered by medical insurance or vision insurance?

Medical eye conditions, including diabetic retinopathy screenings, eye infections (red eye), dry eye syndrome, eye injuries, and glaucoma evaluations, are billed directly through major medical insurance, not routine vision insurance.

Does Medicare cover routine annual eye exams versus medical eye conditions?

Original Medicare (Part B) does not cover routine refractive eye checkups or glasses. However, Medicare covers medical eye exams and diagnostic testing for conditions such as glaucoma, diabetic retinopathy, age-related macular degeneration, and cataracts.

What payment options and credit cards do you accept?

Major payment methods are accepted, including cash, debit cards, and credit cards (Visa, MasterCard, Discover, and American Express). Flexible spending and financing options are also supported.

Do you offer monthly financing or payment plans for high-end eyewear or specialty treatments?

Yes. Healthcare financing options, such as CareCredit, are accepted. CareCredit offers flexible monthly payment plans (including interest-free promotional periods for qualifying purchases) to help manage out-of-pocket costs for specialty contact lenses, luxury frames, or advanced dry eye procedures.

Why doesn’t health insurance cover IPL or radio frequency (RF) therapy for dry eye, and what payment options are available?

Intense pulsed light (IPL) and radio frequency (RF) therapy treat meibomian gland dysfunction and ocular rosacea at the root cause, but major insurance carriers currently classify them as elective procedures. You can pay out of pocket with FSA/HSA cards or use CareCredit promotional financing.

What documents and insurance cards should I bring to my appointment?

Bring a valid photo ID, your vision insurance card, your major medical insurance card, your current eyeglasses, any contact lens boxes or prescription details, and a current list of medications.

How can I submit my current eyeglasses or contact lens prescription before my exam?

You can bring your physical glasses/lens packaging to your visit or submit your previous prescription information during the online intake registration process prior to your appointment.

How much does a contact lens exam and fitting cost with vs. without insurance?

A contact lens evaluation is an additional service performed alongside the comprehensive exam.

• Without insurance: Contact lens exams start at $125 and go up depending on the type of lenses: spherical, toric (astigmatism), multifocal or specialty. This generally includes your fitting, trial lenses and follow-up visits. Contact lenses are not included.
• With insurance: Many vision plans offer a fitting allowance or a fixed copay (typically $10 to $60) for standard contact lens evaluations.

What is a refraction fee, why is it billed separately during an eye exam, and is it covered by insurance?

A refraction is the specific portion of the exam that determines your optical prescription (testing "which lens is clearer, 1 or 2"). Routine vision plans cover the refraction, but major medical insurance (including Medicare) classifies refraction as a non-covered service. When an exam is billed through medical insurance, a separate out-of-pocket refraction fee (typically $40 to $50) applies.

How much do specialized medical tests (such as glaucoma evaluations, OCT scans, or visual field tests) cost out-of-pocket?

When paying self-pay without insurance, individual specialized diagnostic tests (such as OCT retinal scans or visual field perimeter) range from $50 to $120 per scan/test. Comprehensive medical disease evaluations range from $150 to $250+. (When medical criteria are met, these are covered by major health insurance after applicable copays or deductibles).