If you wear contact lenses, your eye doctor is likely charging you an additional fee that vision insurance may not cover.
I remember the first time that I went to get a contact lens exam as an adult and being surprised to see the “contact lens fitting fee” as an item on my bill — and I’ve been paying that fee every year since then.
I’ve spent the past few weeks trying to find out more about this fee and why we as consumers have to pay for it. Here’s what I learned…
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What you need to know before you pay a contact lens fitting fee
To ask for an explanation of the contact lens fitting fee, I first called and emailed the American Optometric Association (AOA). The organization got back to me a few days later with this response:
“We were checking with our legal counsel, as we don’t compile or comment on charges/costs such as contact lens fitting fees assessed by individual doctors of optometry. It can vary from state to state and practice by practice.”
After striking out with the AOA, I began searching online for the answers that I needed. Google led me to VSP, which is one of the leading vision benefits providers in the United States.
VSP’s website states that the contact lens exam (fitting and evaluation) is in addition to your routine eye exam.
I suppose that makes sense, but my eye doctor always lists the routine eye exam as a “comprehensive eye exam” on my bill. If it’s comprehensive, shouldn’t it include contacts and not just glasses?
Here’s more about the difference between a routine eye exam and a contact lens exam, according to VSP:
Routine eye exam
- Obtain your glasses prescription
- Looks for vision problems
- Determine serious medical conditions such as glaucoma, cataracts, diabetes, and even cancer
Contact lens exam
- Obtain your contact lens prescription
- Measure your eye surface to determine what size and type of contacts are best for you
- Verify that the contact lenses fit correctly on the eye
This explanation from VSP helped me understand the purpose of a contact lens fitting, but I’m still a little puzzled why I pay the fee every year to purchase the same brand of contacts. (Leave a comment below if you know the answer.)
To try to learn a bit more, the next stop I made was to my eye doctor’s office to talk to one of the associates face to face…
When I sat down and asked him what the contact lens fitting fee is all about, he said it’s charged because vision insurance providers only view glasses — not contacts — as “medically necessary.”
That explains why my vision insurance covers all but $25 of the $175 comprehensive exam and not the contact lens fitting fee.
Before I left the optometrist’s office, the associate told me that benefits providers like VSP and EyeMed may cover part of the fitting fee with some vision insurance plans.
For example, VSP’s website says it provides 15% off contact lens exam services and the copay won’t be more than $60.
I called up several other vision insurance companies and learned that they may allow you to use part of your contact lens allowance to offset the fitting fee that your eye doctor charges.
Key takeaway
If you get vision benefits through work, you may not have a choice of insurance — but you do have a choice of optometrists.
To save a few bucks, call multiple eye doctors that are in your network and ask them how much it’s going to cost you for a contact lens exam with whatever insurance provider you have.
We polled our Twitter followers and most say the fitting fee is between $50 and $75:
How much did you pay for your last contact lens fitting? #poll #health
— Clark Howard (@ClarkHoward) June 20, 2018
Once you’ve paid for the contact lens exam and fitting fee, your optometrist is required by law to provide you with a prescription.
Money expert Clark Howard says you may be able to save even more money by taking that prescription elsewhere to purchase your contacts from a discounter like Costco, which offers its Kirkland Signature brand of lenses.
