Why am I being charged more for a contact lens exam than for a routine eye exam? - Provision Eyecare (2024)

FAQs

Why am I being charged more for a contact lens exam than for a routine eye exam? - Provision Eyecare? ›

This is because a contact lens prescription requires all of the testing that's done in an annual routine eye exam plus additional testing that must be charged out separately to comply with vision insurance charges.

This exam is more expensive than comprehensive eye exams because more testing is needed to fit you for contacts. If you are concerned about the cost of the contact lens exam, we highly recommend becoming an Eyecare Club member.

Depending on the type of lenses you require and the complexity of your case, fees range anywhere from $45 to $350 annually for the contact lens evaluation fee.

Comprehensive Eye Exam VS Exams for Contact Lenses

Comprehensive eye exams are an in-depth vision and eye health exams that test your visual acuity and for certain eye diseases. Exams for contacts, by contrast, only check your visual acuity and fit you for contact lenses.

Free contact lens assessment with every eye test (Includes NHS eye test entitlement).

Simply put, a Contact Lens Exam is a Routine Eye Exam on steroids, therefore, it is of an additional cost. If you wear contacts, you are required to have an annual Contact Lens Exam in order to maintain your prescription (even if your prescription isn't changing).

Your fitting/evaluation fee will cover your initial fitting/evaluation, any trial contacts the doctor prescribes, and one Contact Lens Evaluation (follow up visit). Most plans provide coverage for contact lenses in lieu of eyeglasses.

Many insurance companies consider contact lenses “cosmetic” so they do not cover contact lens evaluation fees. If your insurance company does pay in full (or a portion) towards your contact lens evaluation, the insurance company may require a contact lens order to be purchased the same day to receive that benefit.

Generally, they cost between $20 and $30 a box. Most people with average prescriptions should be able to get a year's worth of contact lenses for $200 to $500.

The average eyewear sale produces a 61 percent gross profit percentage, or $138 gross profit. Typical contact lens transactions involve two-box sales, generating $80 in revenue, a 47 percent gross profit percentage, and $38 gross profit.

Do I need a separate eye test for contact lenses? ›

Answer: Yes. Contact lens check-ups are designed to check the condition of the front surface of the eye that's in contact with the lens, and to check the quality of your vision with your lenses in.

The Importance of a Comprehensive Eye Exam

During this exam the eye doctor will determine your prescription for eyeglasses, however this prescription alone is not sufficient for contact lenses. The doctor may also check for any eye health issues that could interfere with the comfort and success of contact lens wear.

You should have a contact lens exam at least once a year to ensure the correct contact lens fit and confirm that contact lens wear is not negatively impacting overall eye health. You may need a contact lens exam more frequently based on your visual needs and risks.

The following procedure codes require authorization from the DHCS VSB. Note: When requesting authorization, the contact lens examination (CPT codes 92310 thru 92312) must be requested with the contact lenses (HCPCS codes S0500, S0512, S0514, V2500 thru V2523, V2531 or V2799).

They'll measure and document the surface of your eyes' corneas, including their curvature and any potential astigmatism. This information is important because contact lenses are placed directly on the corneal surface. Nothing touches your eyes during this part of the exam.

Answer: Once you are over the age of 60 you are entitled to a free eye examination through the NHS, usually every two years. If not, you might still be eligible for help based on income by completing and sending off an HC1 form which you can get from any post office or your opticians.

Prices for contact lenses go up as the refractive error or specialty needs increase. The most expensive lenses are bifocal or multifocal lenses or those correcting for astigmatism (irregular corneal shape) or presbyopia (farsightedness related to age).

Contact lenses can be more expensive than glasses, with factors like brand, type (daily, monthly, or bi-weekly), and lens technology influencing the price. Daily disposable lenses, while convenient, tend to be pricier compared to two weekly and monthly contact lenses.

The answer is usually yes unless your doctor specifically tells you otherwise. Wearing your contacts will help your doctor get a more accurate measure of your prescription and determine if your lenses are causing any problems.

An eyeglass prescription is not a substitute for a contact lens exam because the two are very different. An eyeglass prescription measures for lenses that are positioned approximately 12 millimeters from your eyes, whereas a contact lens prescription measures for lenses that sit directly on the eye's surface.