How fees work
Insurance we work with
A routine eye exam is billed to a vision plan. A visit about a symptom, an eye health check or a follow-up is billed to medical insurance, and many visits mix both. Sessions are not a routine vision plan benefit; some medical plans pay part of them, depending on the reason for the visit and the plan. Medicare does not cover routine eye exams or glasses, with a few exceptions.
Vision plans, for routine exams, glasses and contact lenses
Medical plans, for eye health visits, the evaluation and some sessions
Medicare, within its limits for eye care
If you pay yourself
Self-pay covers the evaluation or exam and the sessions you choose. Glasses, contact lens fittings and replacement lenses are billed separately. We tell you what each part will cost before you decide, and we do not treat a price quoted by phone as a promise.
The evaluation or exam
Sessions, in the plan the doctor writes
Glasses and contact lens fittings
Receipts for reimbursement
Ask for an itemized receipt and send it to your plan. The plan decides what it reimburses.
An estimate in advance
If you pay without insurance, you have the right to a Good Faith Estimate in writing before your visit. Ask when you book. If a bill comes in at $400 or more above the estimate, you can dispute it.
Checking your benefits
Before your first visit, Montserrat checks your benefits where she can and tells you what she finds. Please confirm with your plan too, because the plan has the final say.
What the first visit includes
The first visit is an evaluation, about 75 minutes with a doctor. It ends with a written plan, or with a referral if sessions are not the right fit. We bill the evaluation when it is done, and sessions begin only when you decide.
Vision plan, medical insurance or you
The usual pattern at this practice. Your plan decides what it pays, and the coordinator checks before you come.
| Visit | Often billed to | Good to know |
|---|---|---|
| Routine eye exam | Often billed toYour vision plan | Good to knowIncludes a glasses or contact lens prescription |
| Visit about a problem | Often billed toYour medical insurance | Good to knowBilled to medical when the visit is about a symptom or a follow-up |
| Neuro-optometry evaluation | Often billed toMedical insurance, or you | Good to knowPlans differ, so we check first |
| Sessions | Often billed toSome medical plans, or you | Good to knowNot a routine vision plan benefit |
| Glasses and contact lenses | Often billed toYour vision plan's eyewear benefit, or you | Good to knowWe tell you what is left to pay |
Your prescription is yours
A copy, every time, without asking.
Your prescription is yours. We give you a copy after your exam and fitting, and you can fill it anywhere. We do not ask you to buy from us, and we do not charge to release a prescription.
Questions about a bill?
Call before your visit and Montserrat will go through it with you.