Costs & Insurance

If you do not have insurance coverage for a routine eye exam, our fee is $170. This is a discounted rate available only when paid in full at the time of service. This fee includes the medical examination of your eyes and refraction. The refraction is the portion of the exam where the doctor determines the prescription you need for glasses. There will be an additional charge for contact lens fittings and checks.

If you do have insurance coverage for routine eye care and Horizon is a participating provider, there is a contracted reimbursement rate that we receive from your insurance company. We will bill your insurance company our standard charge, and you will receive an explanation of benefits from your insurance company.

Please note that if you have a deductible or co-insurance, your responsibility will be a portion of our contracted rate and not the $170 price described above. It is important to note that insurance companies frequently deny the refraction portion of your eye exam as a non-covered benefit. In these circumstances, the patient is responsible for the cost of refraction.

Refraction is the procedure performed by an eye doctor to determine the prescription needed for eyeglasses. We use either a phoropter, fitted with various lenses, or our Epic machine to perform the refraction.

As dictated by the federal government, refraction is a non-covered service that must be billed separately from the exam. Because Medicare has determined that this service is non-covered, some medical insurance providers have mandated the same policy. Medicare and most insurance companies require that patients pay for the refraction separately from the exam.

To find out if your plan covers refractions, please call the customer service number on your insurance card and ask if refraction services, represented by procedure code 92015, are covered.

As an alternative to the comprehensive eye exam, Horizon Eye Care offers optomap, a non-dilated eye exam that evaluates retinal health and the overall well-being of patients’ eyes quickly and painlessly. Most insurance policies do not cover optomap. Our current rate is $40, which is due at the time of service.

Patients who wear contact lenses require annual evaluations. During the exam, the doctor assesses your eyes to make sure your cornea, lids and lashes are healthy. He or she also checks to see if your vision with contacts is stable. If you are an existing contact lens wearer, the doctor must evaluate your current lenses to make sure they are still satisfactory in fit and vision.

For patients who have not previously worn contact lenses, the doctor will determine whether you are a candidate or not.

• Soft or Gas Permeable with or without brand change
• Re-validates your prescription for one year

• Soft or Gas Permeable
• Upgrade in lenses including Multifocal, Toric or Monovision
• Re-validates your prescription for one year

• Soft or Gas Permeable
• Includes Insertion and removal and 90 days of follow-up care
• Spherical, Toric, Monovision and Multifocal
• Includes Insertion, removal and 90 days follow-up care

• Keratoconus, Corneal Disease and medical treatment

Evaluation fees include insertion and removal instructions (if needed), initial solutions and up to 2 pairs of trial contact lenses. Follow-up time is allotted for you to complete your contact lens evaluation. Established contact lens wearers receive 30-day follow-up and a new contact lens wearer receives 90 days follow-up care. Contact lens technicians review contact lens wearer care to determine if follow-up is necessary. New contact lens wearers are required to have a follow-up visit 1-2 weeks after starting to wear the lens. If any eye problems arise, you must contact your doctor immediately. Improper use of contact lenses may result in permanent visual impairment.

All fees are due at the time of service and are non-refundable. Evaluation fees do not include the price of contact lenses.

If your current health insurance policy does not cover vision care, and you find that you need it, consult your insurance company during the Open Enrollment period at the end of each year. A representative at the insurance company should be able to guide you. Take a look at the general list of insurance companies whose coverage Horizon Eye Care accepts.

Here is a general list of insurance companies whose coverage we accept:

• AARP Medicare
• Absolute Total Care SC Medicaid Plan (Medical Only)
• Advicare (Pediatric Medical Only)
• Aetna
• Americas First Choice Medicare
• Bind On Demand
• Blue Choice HealthPlan
• Blue Cross Blue Shield of NC (not including Blue Local)
• Blue Cross Blue Shield of South Carolina
• Blue Medicare
• Blue Cross Blue Shield National Network
• Federal Blue Cross Blue Shield (Medical Only)
• Blue Choice SC Medicaid Plan (Medical Only)
• Bright Health
• Care N’ Care (Medical Only)
• Care Improvement Plus Medicare PPO (Medical Only)
• ChampVA
• Cigna
• Cigna Healthspring Medicare
• Community Eye Care
• Consumers' Choice Health Plan
• CoventryOne
• Evercare Medicare (Medical Only)
• Eyemed (Plans A-H)
• First Health PPO
• GEHA
• Healthgram
• Humana
• Humana Medicare
• Medcost
• Medicaid of NC
• Medicaid of SC
• Molina Healthcare SC Medicaid (Pediatric Medical Only)
• Select Health of SC Medicaid (Pediatric Medical Only)
• Wellcare SC Medicaid (Medical Only)
• Medicare
• Multiplan
• PHCS
• PruittHealth Premier Medicare
• Services for the Blind NC
• Time/Assurant
• Tricare (not including Tricare Prime)
• United Healthcare
• United Healthcare Medicare Plans
• Vision Service Plan (VSP)