Why Your Insurance Might Not Cover Everything: What to Know Before Your Eye Exam

If you’ve ever come in for an eye exam thinking, “This should be covered!”—only to get a surprise copay or bill later—you’re definitely not alone. One of the most confusing parts of healthcare is figuring out what your vision insurance actually covers… and what it doesn’t.

Let’s break it down.

Vision Insurance ≠ Medical Insurance

Our patients most commonly have VSP or EyeMed, which are vision plans, not full medical coverage. These usually help with:

• Routine eye exams for glasses
  
• Standard contact lens fittings
• Allowances towards glasses and contact lenses
  
• Basic lens enhancements
  

They don’t usually cover:

• Medical eye visits (red eyes, floaters, allergies, etc.)
  
• Specialty tests like OCT or Optomap imaging
  
• Specialty contact lens fitting fees (Orthokeratology, MiSight, etc
  

Common Charges That Surprise Patients

Here are a few things we’re transparent about from the start:

• Contact Lens Evaluation Fees: Some vision plans may cover a portion of the fee or even all of it. This varies widely based on your vision plan
  
• Optomap Imaging: This widefield scan gives us a detailed look inside your eye without dilation. It’s incredibly useful—but often not covered by vision plans.
  
• Copays and Materials Fees: Depending on your plan, you may have to pay a portion of the exam or glasses/lens cost out-of-pocket.
  

Why We’re Upfront About Pricing

At Vision Care Center, we always explain all costs before your exam begins. We want you to feel informed—not surprised. If there’s ever a question about coverage, we’ll check ahead of time and walk you through your benefits.

Final Thoughts

We know insurance is confusing. That’s why we take the time to explain it, so you can make the best decision for your eyes and your wallet. Questions? Just ask—we’re happy to help.

👉 Book your next exam today—and let’s review your benefits together
📅 Schedule online or call us at (425) 746-2122