MEDICAL & VISION
INSURANCE

Call your insurance provider or HR department and ask. It is the patient’s responsibility to tell us whom to bill. We can only check VSP, because that is the only plan with which we participate. We do not have access to other vision plans to check for your enrollment.

Yes. We are likely in network for your medical insurance but out of network for your glasses/contacts plan. If there is a medical reason for your visit (i.e., allergies, cataracts, floaters, dryness, etc.), then having an eye exam here is billed the same as going to see any other medical specialist. You would pay your medical specialist copay, and the exam and any imaging or procedures would be billed to your medical insurance. You will not be able to use your vision plan benefits in our optical shop. However, we offer 30% off glasses and 20% off contact lenses for patients in this situation. Alternatively, you could have your exam here and take your prescription to an optical store that participates in your vision plan.

You may have out-of-network benefits. Sometimes, patients are able to pay us in full and then submit to their insurance for reimbursement. Check with your plan before you schedule your appointment.

No, you don’t. Many eye doctors avoid certain vision plans because they limit patient options to low-quality materials on restrictive schedules and provide poor reimbursement, incentivizing rushed exams. You can see an eye doctor using medical insurance or pay out-of-pocket for the materials you want. We do not accept most vision plans because we offer thorough exams and high-quality lenses and frames.

Vision plans reimburse eye doctors for routine vision care, like an annual well visit. Extra diagnostic testing and the treatment of ocular diseases are billed to medical insurance. Specialty services like myopia control, custom contact lenses, and dry eye treatments are also outside routine care. Some plans may have carve-outs for certain services.

Every plan has its own rates. Most medical insurers and vision plans cover an annual eye exam, including a refraction (which is better, 1 or 2?) and a dilated eye exam. Problem-specific exams, procedures, and imaging may be covered by medical insurance but could be subject to your deductible.

Coordination of Benefits (COB) occurs when your medical insurance is billed for your visit, and the remainder not covered is sent to your vision plan. This can save patients money, but every insurance plan differs.