Contact lenses in California

October 30, 2014 8:53 PM

Is a lens fitting a requirement in California? If so, how much does one typically cost?

I recently moved to California from Pennsylvania. I need to re-stock my supply of contact lenses, so I made an appointment with a local office and gave them my insurance information. My current policy provides for an exam and materials for a $30 co-pay. When I went to the office, I was told there would be an additional fee of $130 for lens "fitting." I've worn contacts for over 10 years, and I know how to put them in, but I was told (condescendingly) that the fitting is a legal requirement in the state. I ended up walking out, but before I make my next appointment, I'd like to know if this could possibly be true.

Thank, MeFi!

posted by null14 to Health & Fitness (15 answers total)

I believe that the term "contact lens fitting" refers to just the part of the exam where they determine your contact lens prescription. Getting your glasses rx is totally different than your contacts rx. A lot of vision insurance companies only cover the main (glasses) exam, and you have to pay extra for the contacts exam.

I recently got an eye exam (in San Francisco) and I actually had two different appointments for glasses and contacts (although that might be because I have some eye problems that meant that the Ophthalmologist spent a long time with me). I've been wearing contacts for 20 years so I, like you, didn't need someone to find me the right brand and show me how to use them.

You should call your insurance and ask exactly what they cover. You should also ask your doctor if there is a discount on the $130 since you do have vision insurance.
posted by radioamy at 9:10 PM on October 30, 2014

Response by poster: Thanks radioamy. Just to clarify, I've had this policy for years, and I've taken advantage of if at least three times with three different doctors on the east coast. Each time the cost has been the same. Ten dollars for the exam, twenty dollars for the materials. At the office I visited today, I was explicitly told that the fitting is an additional requirement in California and that it isn't covered by many policies. I have lived in New Jersey and Pennsylvania, and contact lenses have always been treated the same as glasses with the same prescription.
posted by null14 at 9:36 PM on October 30, 2014

Sounds like bullshit to me. I've lived in California for over a decade, gone to an optometrist just about once a year, had several different vision insurance providers (and have gone without a vision insurance provider) and have never ever been charged a "lens fitting" fee.

I HAVE been asked to come back a week after a new kind of lens was prescribed to make sure it fit correctly with no irritation or difficulties, but there was no fee for that 5-minute visit.
posted by erst at 10:43 PM on October 30, 2014

In IL a prescription for contacts is only good for 2 years. After that you must get a full examine - even if you've worn contacts for 45+ years and your prescription has been the same for a decade. Otherwise, you might continuing ordering your contacts online and never spend a dime at the local optical chain store.

I'm sorry I can't help you with CA - just wanted to let you know that this isn't unheard of.
posted by she's not there at 11:12 PM on October 30, 2014 [1 favorite]

Do you have VSP?
posted by potsmokinghippieoverlord at 12:01 AM on October 31, 2014

Response by poster: Yes, potsmokinghippieoverlord, I do.
posted by null14 at 12:17 AM on October 31, 2014

When I tried contacts once upon a time, in California about 5 years ago, the fitting was optional. The eye check was annual.
posted by rhizome at 2:23 AM on October 31, 2014

I'm in CA. My prescription is valid for a 12mos (note that I usually stock enough lenses to last me more than a year). When I book the appointment there is a straight exam fee ($89 if paying cash) which includes a glaucoma test and checking to see if my prescription has changed. No one has ever mentioned a "fitting" fee, and I know it's not a fee being passed on to my insurance without my knowledge.
posted by vignettist at 5:06 AM on October 31, 2014

If I don't get back to the eye doctor within 18 months they process the appointment like a "new patient" and stick me for a lens fitting, even though I've been wearing contacts for almost 30 years, and they don't actually do the lens fitting. It just a BS move to protect revenue, just like contact prescription only being good for one year. This is in VA.
posted by COD at 5:10 AM on October 31, 2014

Have you tried calling your insurer? Alternatively, try calling other eye doctors, but asking up front what the total calculated cost would be to you.
posted by ellerhodes at 6:05 AM on October 31, 2014

I wonder if it's something to do with being a new patient?

Also I agree that you should call other doctors and ask about price and what your insurance covers.. Memail me if you need a rec in SF.
posted by radioamy at 7:17 AM on October 31, 2014

I believe that the term "contact lens fitting" refers to just the part of the exam where they determine your contact lens prescription

I believe it's more than that. Especially if I've had to change brands, the doctor usually has you insert a sample pair of lenses then he checks the eyes again for proper curve fit and irritation on the cornea/eyelids.

But, still, that shouldn't cost $130.
posted by JoeZydeco at 8:32 AM on October 31, 2014

My experience has been that eye doctors charge me a fitting fee only if I'm getting a new kind/brand of contact lens (I think because I have to come back to see how well the lens fit, etc.). If I'm staying with the same lenses that I've been wearing, I only get charged an exam fee.
posted by Comrade_robot at 8:32 AM on October 31, 2014

I think it depends on where you go. Some places are just more inclined to take you for every penny they can. I've gone to two different doctors in the last couple of years and the first one didn't charge me for the contact exam but the other one charged me $80. Needless to say, I'll be going back to the other doctor
posted by hazel79 at 8:33 AM on October 31, 2014

I believe that the term "contact lens fitting" refers to just the part of the exam where they determine your contact lens prescription

For me it was because I had never worn them before and it was a 15min tutorial on how to put them in.
posted by rhizome at 10:21 AM on October 31, 2014