At Eye See Optique — Arlington, we want medical eye care to be as accessible as possible. Our eye doctor accepts many major medical insurance plans, and our team is here to help you understand how your coverage may apply to your visit.
How Insurance Works for Eye Care
Eye care insurance can be confusing, especially when medical visits, vision benefits, and specialty services overlap. We want to help you understand how coverage works, what’s billable, and what to expect before you arrive.
In general, medical insurance is billed for visits related to disease or injury, while vision benefits are usually used for routine eyewear and wellness services. Depending on your plan and the reason for your visit, we may bill one or both.
Catering to both medical and Routine Vision Coverage
The type of insurance used for your visit is based on your exam findings and final diagnosis.
When your visit involves a medical eye concern—such as dry eye disease, diabetes-related eye conditions, glaucoma, infection, inflammation, or eye injury—your medical insurance is typically billed.
When your visit is focused on a routine eye exam to update glasses or contact lens prescriptions and to check overall eye health without a medical diagnosis, your vision benefit usually applies.
In some cases, both medical and vision coverage may be involved during the same visit. Our team will always explain how your visit is billed and answer any questions you may have.
Copays, Deductibles & Out-of-Pocket Costs
Most insurance plans include copays, deductibles, or coinsurance amounts that are your responsibility at the time of service. These amounts are determined by your insurance plan, not by our office.
Before your appointment, you are welcome to contact your insurance provider to ask about:
- Office visit copays
- Annual deductibles
- Specialist benefits
- Any limits that may apply to eye care
If you share your insurance information with us in advance, we can often provide a general estimate of what you might owe. Final amounts depend on how your claim is processed by your insurer.
Self-Pay & Out-of-Network Visits
If you do not have insurance or if we are out-of-network with your plan, you can still be seen at Eye See Optique — Arlington. We offer self-pay options for exams and services, and we can provide an itemized receipt so you may submit it to your plan if it offers out-of-network reimbursement.
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) may be used for eligible eye care expenses. Please check with your benefits administrator for details about what your account covers.
Some specialty services, such as medically necessary contact lenses, certain imaging tests, or advanced dry eye treatments, may or may not be covered depending on your diagnosis and insurance plan. In some cases, prior authorization or additional documentation may be required.
Our team will review any recommended tests or treatments with you, including whether they are likely to be covered and what out-of-pocket costs you might expect.