The cost of eye care and prescription eyewear can be of real concern. We want to help you make the most of your benefits. We participate in a large number of medical and vision insurance plans. We encourage you to give us a call at (425) 831-2020 or send us an email if you'd like to confirm that we participate in your particular medical or vision plan.
In many cases, vision plans can lower the annual expenses of routine vision care and obtaining prescription eyewear. A vision plan is not the same as health insurance. A vision plan is a wellness benefit designed to provide routine eye care, prescription eyewear, and other vision-related services at a reduced cost.
Some patients put off having an eye exam because they don't have vision insurance. However many eye conditions are appropriately covered by medical insurance. The reason for your visit with us drives whether your vision plan or your medical plan is appropriate to use. For example, if you would like a routine check-up and update your glasses, this would be covered under your vision plan or you could choose to pay for this service out-of-pocket. However, if you are having your exam because of a medical eye condition, then your medical insurance will be billed. A number of different medical eye conditions are listed at the bottom of this page.
A refraction is a term for the service of determining your eyeglasses prescription ("Better one or two?"). This is only a small part of both routine vision and medical eye exams. Many vision plans cover the cost of refraction and most medical plans do not. If refraction is performed as a part of your medical eye exam, then in most cases you would be responsible for this as an out-of-pocket cost. Our fee for a refraction is $45.
Contact lenses are generally not covered under any medical insurance plans, and usually, it is best to schedule your visit for contact lens fittings and care separately from medical eye exams. Many vision plans do cover the cost of contact lens exams as well as the contact lenses themselves. The coverage is going to vary widely from plan to plan, and we are happy to help you verify your contact lens benefits.
All patients are welcome in our optical shop, regardless of their insurance coverage. If you have a vision plan, we can assist you with finding out your coverage. For those paying out of pocket, we have a range of options at different price points, and we want to help you find the best option for you to provide a clear, comfortable vision.
Premera Blue Cross
Regence Blue Shield
Blue Cross Blue Shield
First Choice Health Network
Regence Blue Shield
Lifewise Health Plan of Washington
Molina HealthCare of Washington (some plans)
Washington State Medicaid
Community Health Plan
Labor and Industries
Benefit Administrative Systems
Bridge Span Health
Physicians Care Network
Mutual of Omaha Insurance company
Asuris Northwest Health
Bankers Life and Casualty
Regence Group Administrators
State Farm Medical
Sterling Life Insurance Company
Zenith American Solutions
There are many, many eye conditions and medical conditions that would be covered by medical insurance. Here is a partial list:
age-related macular degeneration
cataracts and cataract surgery
corneal infection or corneal ulcer
drooping eyelids blocking vision
diabetic ocular exam
flashes and floaters
glaucoma and glaucoma procedures or surgery
glaucoma risk factors (aka "glaucoma suspect")
high-risk medication ocular exam (e.g. hydroxychloroquine, Plaquenil, or long-term oral steroids)
The distinction between when it is appropriate to use vision insurance and when medical insurance is appropriate can be extremely confusing. If you have any questions please just give us a call at (425) 831-2020 or send us an email to ask and we'll do our best to help you navigate the best option for your situation.