What is the difference between a comprehensive eye exam and a contact lens evaluation ?

A comprehensive eye exam involves the determination of the spectacle prescription. Drops are often used to dilate the pupils and the eye health is evaluated. A contact lens evaluation (or fitting) is a separate specialized service. It includes the measurement of the corneal curvature, the selection of the appropriate contact lenses based on your lifestyle and corneal physiology, and the necessary follow-up visits to assure the desired result. One-on-one instruction is provided for new contact lens wearers and sometimes multiple visits are required, depending on the complexity of the case.

Since it is an additional service, a contact lens evaluation is usually billed separately from the eye exam. Some offices lump this additional service fee into the eye exam and refer to the entire package as the contact lens exam. The end result is the same: the additional fees are added onto the eye exam. In our offices, the contact lens service fees are charged separately. It is just more straightforward to the patient that way.

Does insurance cover the contact lens evaluation ?

All vision plans recognize a contact lens evaluation as separate specialized service. Most offer some sort of contact lens service benefit. Some do not.

What about the contact materials ?

Some vision plans offer a certain allowance towards contact lens materials. It depends on the details of your particular plan. After the allowance is met, the patient pays any remaining cost balance.

What is the difference between a spectacle prescription and a contact lens prescription ?

A spectacle prescription is determined at a routine well-vision exam or a comprehensive exam. It specifies the power of the eyeglasses. A contact lens prescription is determined only after the completion of a contact evaluation (or fitting), which is a separate specialized service. It specifies the brand of contact lens, the base curve, the diameter, the power, and any special instructions if needed. The spectacle Rx and the contact lens Rx may be quite different for the same patient.

How long is a contact lens prescription valid ?

One year.

When it comes to insurance, what is the difference between a vision plan and medical plan ?

A vision plan covers routine uncomplicated well-vision exams. A medical plan covers visits in which there are specific medical symptoms, a medical condition is detected, or a medical treatment is initiated. We are required to bill the insurance carrier that most accurately reflects the nature of your visit. Often, this involves your medical plan. We cannot bill medical conditions to your vision plan. It will result in a denied claim. Keep in mind also, that depending on the plan you have selected, copays and deductables often apply. To keep costs down, we kindly ask that these are paid on the date of service.

Can I use my flexible spending account (fsa) for examinations, glasses, and contacts ?

Yes. This is a great way to pay for services and materials not covered by insurance. It allows you to budget for the glasses and contacts you really want. Some patients also use flexible spending accounts for LASIK surgery.

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