Why is there a Contact Lens Exam fee?
This fee covers the extra tests performed by the doctor along with any necessary follow-up visits and trial lenses. These procedures are only done on patients that wear contacts; it is in addition to the services provided during the annual eye exam.
Why doesn’t my insurance cover that fee?
Insurance companies view most contact lenses as elective vision correction and generally offer a discount towards the contact fitting fee. In rare occasions, insurance companies may consider contacts as medically necessary and cover a portion or all of a contact fitting, such as those for patients with conditions like keratoconus. Most insurance companies take the position that if your vision can be corrected with glasses, then contacts are not medically necessary and therefore are not covered as extensively as glasses and your annual eye exam. If you believe that should change, then we urge you to contact your insurance company and discuss the matter with them.
How much is the Contact Lens Exam fee and how is that determined?
There are different levels of charges based on several factors. You may view a full list of our annual eye exam and contact lens fitting charges here. We are more than happy to discuss the full range of prices up front with any patient based on previous contact lens history and what the patient desires to use going forward. The doctor can only determine the exact level of the fitting after completing the exam, because that is when all of the patient’s needs have been assessed. Those factors include:
1) The complexity of the fit: Many options for vision correction exist and have varying levels of complexity in order to determine the optimal Rx. These options include spherical lenses (what many patients are most familiar with), toric lenses for astigmatism, monovision, and bifocal lenses.
2) Patient’s ocular health: The condition of the eyelids, conjunctiva, cornea, and tear film all affect the optimal contact lens material, shape, and care. Even your general health and any conditions you might have can affect ocular health; these must be taken into consideration as well.
3) History of previous eye surgeries or injuries: corneal irregularities or eye sensitivity can be brought on by eye surgeries or injuries. In these cases more care may be required in order to prevent irritation or complications.
4) New patient vs. established patient: New patients require longer appointments, because there is more history to collect and options to discuss. Established patients pay a lower fee; our doctors have a previous knowledge of the patient and any conditions they might have, which makes the process quicker.