Brooks Eye Associates' office policy is to perform at least one refraction per year as a diagnostic part ofa cataract evaluation or medical evaluation. A refraction is a diagnostic test used to determine the best possible function of the eye. It provides medical information necessary to properly evaluate eye health and look for eye disease.
Each insurance may cover the refraction differently, and it's possible it may not be covered at all. Medicare is a plan that does not cover the refraction, so for Medicare patients, we will collect the refraction fee of $49 on the date of service. For all other insurance plans, our insurance department will do their due diligence to verify your plan benefits, and we will collect for the refraction according to your specific plan's coverage.
If the refraction is a non-covered service according to your plan, we will collect the $49 out-of-pocket rate for this service. If the patient requests a refraction specifically to receive an eyeglass prescription, the patient must be seen by one of our optometrists on staff specifically for this service, in conjunction with an office visit. This service is only available to patients who do not already have a primary optometrist.
I have read the above information and understand that in many cases, a refraction is a non-covered service. I accept full financial responsibility for the cost of the refraction as dictated by my insurance plan, or up to the amount of $49 if my insurance plan does not cover it. I understand that any co- payments, co-insurance, or deductibles that I may owe for my visit and/or other testing performed, are separate from and not included in the refraction fee.