Cost Questions FAQs



How much does a contact lens exam cost?

Contact lenses are determined by the FDA (Federal Drug Administration) to be medical devices and like all prescription devices, contacts must be monitored on a yearly basis. Good vision and eye comfort does not ensure a healthy contact lens fit. Though not all problems are vision threatening and may cause only discomfort and irritation, without proper follow-up care you can delay correction of a potentially harmful situation.

Contact Lens Evaluation/Examination

All patients require a contact lens evaluation every year. In doing so the doctor assesses your eyes to make sure your cornea, lids, and lashes are healthy, and also that your vision with contacts is stable. If you are a first time contact lens wearer the doctor also assesses if you are a candidate for contact lenses. If you are an existing contact lens wearer the doctor must evaluate the current lenses you are in and make sure they are still satisfactory in fit and vision. This is done during your annual exam.

Contact Lens Evaluation Fees

Renewal of contact lens fit and power – $70.00

  • Soft or Gas Perm with or without brand change
  • Re-validates your RX for one year

Renewal of contact lens fit and power – $85.00

  • Soft or Gas Perm
  • Upgrade in lenses including Multifocal, Toric or Monovision
  • Re-validates your RX for one year

New Standard/Premium Contact lens evaluation – $120.00

  • Soft or Gas Perm
  • Includes Insertion and removal and 90 days of follow-up care
  • Spherical, Toric, Monovision and Multifocal
  • Includes Insertion and removal and 90 days follow up care

Specialty contacts lens evaluation – $229.00

  • Keratoconus, Corneal Disease and medical treatment

Evaluation fees include insertion and removal instructions (if needed), initial solutions, and up to 2 pairs of trial contact lenses. Follow up is allotted for you to complete your contact lens evaluation. Established contact lens wearers receive 30 day follow up and a new contact lens wearer receives 90 days follow up care. Contact lens technicians will review contact lens wearer care and determine if follow up is necessary. New contact lens wearers are required to have a follow up visit 1-2 weeks after starting the lens. If any eye problems arise you must contact your doctor immediately. Improper use of contact lenses may result in permanent visual impairment.

All fees are due at the time of service and are non-refundable. Evaluation fees do not include the price of the contact lenses.

How much do you charge for a routine eye exam and what is included in the exam?

If you do not have insurance coverage for a routine eye exam, our fee is $170. This is a discounted rate available only when paid in full at the time of service. This fee includes the medical examination of your eyes and refraction. The refraction is the portion of the exam where the doctor determines the prescription you need for glasses. There will be an additional charge for contact lens fittings and checks.

If you do have insurance coverage for routine eye care and Horizon is a participating provider, there is a contracted reimbursement rate that we receive from your insurance company. We will bill your insurance company our standard charge and you will receive an explanation of benefits from your insurance company.

Please note that if you have a deductible or co-insurance, your responsibility is a portion of our contracted rate due to your insurance company and not the $170 price described above. It is important to note that insurance companies frequently deny the refraction portion of your eye exam as a non-covered benefit. When this happens the patient becomes responsible for this charge.

Can you bill me for my copay?

No. Our policy is to collect copays, prior balances, non-covered charges (such as refractions) and unmet deductibles at the time of service.

Why do I have to pay for refraction separately?

A refraction is the procedure performed by an eye doctor to determine the prescription needed for eyeglasses. We use a phoropter, fitted with various lenses, or our Epic machine to perform the refraction. This is the part of the exam where the doctor or technician asks questions such as "which is better, one or two?"

As dictated by the federal government, the refraction is a non-covered service that must be billed separately from the exam. Because Medicare has determined that this service is non-covered, some medical insurance carriers have mandated the same policy. Medicare and most insurance companies require that patients pay for the refraction separately from the exam.

 

Can Horizon Eye Care fill my Medicaid prescription for eyeglasses written by a non-Horizon doctor?

Horizon Eye Care will only bill and manufacture eyeglasses through North Carolina Medicaid for patients under the age of 21 who have obtained their current prescription from a Horizon Eye Care physician.

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Cost Questions FAQs

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