Medical Eye Exam


Medical Eye Exam

A “routine” vision exam often contains the same elements as a “medical” eye exam. Also, the type of eye doctor you see doesn’t determine if the exam is termed routine or medical. Either an optometrist or an ophthalmologist can perform the exam. It’s the insurance companies that classify an exam and determine if it’s a “medical eye exam” or not.

The reason for being seen and the resulting diagnosis are the two big factors that insurance companies use to make this determination. This is also how they decide for what services they will pay.

A routine vision exam usually produces a final diagnosis, such as “nearsightedness” or “astigmatism” that will most often be treated with corrective lenses in the form of contacts or glasses.

If you have a medical complaint such as dry eyes or or a diagnosis like conjunctivitis or cataracts this will most likely be determined a medical eye exam and need a medical treatment.

Depending on your policy, your medical insurance may cover a medical eye problem, but may not pay for the exam if it is a “routine” eye exam. Vision Insurances usually only cover routine eye exams.  Details of differing coverage can get quite complicated.  So make sure you are familiar with what insurances you have and what they cover.  

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