Frequently Asked Questions
How often should I get my eyes checked?
It is recommended to have your eyes checked every 1-2 years. For patients with medical conditions such as Diabetes, High blood pressure and Rheumatology conditions, cataracts, glaucoma, etc, it is recommended to have an examination at least once a year, if not more often. The frequency will be determined by the medical status of your condition.
How much is my visit?
The office fees will range depending on your visit and the complexity of the visit. Please call each office for more details>
Is there a fee for my follow up visits?
Yes, there will be a fee associated with each office visit
What are your appointment or scheduling policies?
We strive to stay on time and minimize wait time. In order to do that, we adhere to the following policies:
-Please call us if you are running late and we could determine whether or not you appointment needs to be rescheduled.
-We do accept Walk-In appointment when the schedule permits. Your visit will be seen after the scheduled appointments.
-We are a medical clinic and do accept Emergency eye appointments. Please call each office for more details>>
-If you cancel within 24 hours or no-showed to your appointment, you will be billed $35 fee.
-Please call us if you are running late and we could determine whether or not you appointment needs to be rescheduled.
-We do accept Walk-In appointment when the schedule permits. Your visit will be seen after the scheduled appointments.
-We are a medical clinic and do accept Emergency eye appointments. Please call each office for more details>>
-If you cancel within 24 hours or no-showed to your appointment, you will be billed $35 fee.
What insurances do you accept?
What do Vision benefits cover?
Vision benefits are typically an added benefit to your Medical Insurance Plan. It is intended to provide basic "wellness" exam for refractive purposes such and nearsighted, farsighted, astigmatism diagnosis. In addition to the exam, there is typically an allowance for the material part for either glasses or contact lens benefits.
These plans will not cover any medical eye care. Medical eye care are any care beyond glasses/contact lens prescriptions, such as eye infections, dry eyes, floaters, diabetes, etc.
Please keep in mind eligibility and benefits are subject to change and it is ultimately the patient's responsibility to know what your coverage is.
These plans will not cover any medical eye care. Medical eye care are any care beyond glasses/contact lens prescriptions, such as eye infections, dry eyes, floaters, diabetes, etc.
Please keep in mind eligibility and benefits are subject to change and it is ultimately the patient's responsibility to know what your coverage is.
What do Medical insurances cover?
Medical Insurances will cover all medical related eye care. Even if you do not have any separate vision insurance, some medical plan will have routine exam benefits with refraction services embedded. Please call your insurance provider for more specific details or give our office a call and we will answer any questions you may have about your insurance coverage. If you do not have any routine exam benefits, you must have a Medical reason to be seen with your medical insurance.
For example, if you came in for an eye exam for blurry vision. It could be just vision changes due to uncorrected refractive error (which glasses will correct and vision benefits will cover) or it could be from diabetic retinopathy or cataract changes that causes blurry vision (which glasses could not correct and medical insurance will be used). Because this exam requires a much more in depth evaluation for a medical reason and not a "wellness" exam, this exam will be considered a Medical eye exam.
Please keep in mind eligibility and benefits are subject to change and it is ultimately the patient's responsibility to know what your coverage is.
For example, if you came in for an eye exam for blurry vision. It could be just vision changes due to uncorrected refractive error (which glasses will correct and vision benefits will cover) or it could be from diabetic retinopathy or cataract changes that causes blurry vision (which glasses could not correct and medical insurance will be used). Because this exam requires a much more in depth evaluation for a medical reason and not a "wellness" exam, this exam will be considered a Medical eye exam.
Please keep in mind eligibility and benefits are subject to change and it is ultimately the patient's responsibility to know what your coverage is.
Why is it so complicated?
Good question! These are the rules set by insurance companies and all medical providers are required to follow them.
A sample of what a Medical health insurance plan might offer:
- Copayment
- Copayment: The payment you make, usually a fixed dollar amount such as $50, each time you visit the doctor or fill a prescription medication. Not all plans have copayments. These typically do not accumulate toward the deductible and is due at each office visit.
- Deductible
- Deductible: The amount you're responsible for paying for covered medical expenses before your health insurance plan begins to pay for covered medical expenses each year.
- Example: $5,000
- Coinsurance
- Coinsurance: Shared costs between you and the health insurance plan. For example, you pay 20 percent of costs and your plan pays 80 percent. These percentages may be different from plan to plan. Some plans may not have coinsurance.
- Example: 20%
- Out-of-pocket maximum
- Out of pocket: The most you will have to pay for covered medical expenses in a plan year through deductible and coinsurance before your insurance plan begins to pay 100 percent of covered medical expenses.
- Example: $6,000
- Example:
- In the example above, you would be responsible for the first $5,000 (your deductible).
- After you have met your deductible of $5,000, you would be responsible for 20 percent coinsurance until you reach your out-of-pocket maximum of $6,000 (in this case, you would be responsible for another $1,000).
- Your health insurance plan would pay the rest of the covered medical expenses (in this case, 80 percent).
- After you have reached your out-of-pocket maximum, you would pay nothing for any additional covered medical expenses for the rest of the plan year.
Reference: "A Guide to Understanding Health Insurance." A Guide to Understanding Health Insurance. N.p., n.d. Web. 04 Aug. 2016.
Do I need to have a Sam's Club membership to see you?
Not at all. We are an independent Optometry office, conveniently located next to Sam's Club. No membership is required!
How does diabetes affect my eyes?
- For patients having Diabetes type 1 or 2, you are at risk for having Diabetic Retinopathy.
- The Diabetes Control and Complications Trial (DCCT) showed that better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar and Hemaglobin A1C levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery.
- Between 40-45% of Americans diagnosed with diabetes have some stage of diabetic retinopathy. This is why it is very importance for you to have a comprehensive Dilated eye exam annually.
What is dilation of the eyes?
- These are eye drops that are placed in your eyes to expand your pupils (the black center of your blue/brown eyes). It typically takes about 15 minutes for the drops to become effective. When your pupil gets bigger, it allows the doctor to see more in the back of your eyes, beyond the central part of the retina, as indicated on the picture. This allows the doctor to check for any abnormalities and changes in the retina typically not seen without dilation.
