How much does an eye exam cost without insurance?

Published eye exam prices

Few optical chains post a cash exam price. These are the ones we could confirm on the retailer's own site:

Many optical stores don't list an exam price on their websites. Call the store and ask what a routine exam and a contact lens exam cost before you go.

What changes the price

• Contact lenses. A contact lens exam adds measurements, a fitting and often a follow-up visit after you try the lenses, so it costs more than an exam for glasses alone.
• Extra tests. Some offices add tests such as retinal photos. Ask whether they are included or billed separately.
• Who you see. Optometrists and ophthalmologists both do eye exams, and each practice sets its own price.
• Bundles. A free exam tied to buying glasses can be a good deal if you need glasses anyway. If you only need the exam, a stand-alone price may cost less overall.
• Location. The same chain can charge different prices in different cities.

What a routine eye exam includes and how often to go

MedlinePlus says a standard eye exam checks your vision and eye health. It usually includes an eye chart, a refraction to find your glasses prescription, side vision and eye movement checks, a pressure check for glaucoma, a slit lamp look at the front of the eye and often a dilated look at the retina and optic nerve.

• Ages 20 to 39, no eye problems: one exam in your 20s and two in your 30s.
• Ages 40 to 54: every 2 to 4 years.
• Ages 55 to 64: every 1 to 3 years.
• 65 and older: every 1 to 2 years.
• Contact lens wearers: every year.

Your eye doctor may suggest more frequent exams based on your risk factors for eye disease, symptoms or other illnesses. An at-home prescription renewal app is not a full eye health exam; Warby Parker says so about its own app.

Get urgent care from an eye doctor or emergency room for sudden loss of vision in one or both eyes (even if brief), new double vision, a shade or curtain over your vision, sudden blind spots or halos, or sudden blurry vision with a red, painful eye. In an emergency, call 911.

Medicare, HSA and FSA

• Original Medicare doesn't cover routine eye exams for glasses or contact lenses, so you pay the full cost. Some Medicare Advantage plans add vision benefits; ask your plan. Medicare has separate rules for eye exams if you have diabetes and for glaucoma screening.
• HSA and FSA. IRS Publication 502 says eye exams count as medical expenses, and so do glasses and contact lenses needed for medical reasons. Warby Parker says you can use HSA and FSA dollars on its exams, eyewear and contacts. Check with your plan administrator or a tax advisor before you count on it.
• Vision insurance is separate from health insurance. If you have it, compare your copay with the cash price; bundle offers like America's Best's can't be combined with insurance.

Ways to pay less

1. Ask for the cash price up front, for both a glasses exam and a contact lens exam.
2. Ask what's included, such as dilation, retinal photos and a contact lens follow-up visit.
3. Compare a bundle with a stand-alone exam. A free exam with glasses only saves money if you were buying the glasses.
4. Use HSA or FSA funds if you have them.
5. Get your prescription in writing so you can shop for glasses or contacts anywhere.

Not sure what a result or prescription means? Ask Gabriel free by app, web, text or voice. For other cash-pay care, see how to negotiate a medical bill and what's HSA eligible.