Routine vs. Medical Eye Exam
On the surface, a routine eye exam and medical eye exam sound like they accomplish the same purpose. But they are actually different exams which look for different potential problems in your eyes. It’s essential to determine the difference between exams since the type may affect your insurance coverage.
A routine eye exam is generally focused on non-medical eye diagnoses like nearsightedness or farsightedness.
In contrast, a medical eye exam looks for health conditions like pink eye, cataracts, glaucoma or diabetic retinopathy.
ROUTINE EYE EXAM
A routine eye exam will use refraction to determine the right prescription for glasses or contacts, if needed. It will also involve an overall evaluation of your eye health.
Diagnoses like nearsightedness, farsightedness, or astigmatism aren’t considered medical exams since these sight problems are not medically harmful.
You should note that a routine eye exam can require a follow-up medical eye exam if the provider discovers a problem during the evaluation. For example, during the evaluation, your eye doctor may notice that your blurry vision is caused by cataracts. At this point, your doctor will recommend a medical exam for your follow-up appointment. Any testing will be scheduled as a medical exam as most vision insurances do not cover testing.
It is important to understand your medical diagnosis, such as glaucoma or diabetic retinopathy. This information is helpful prior to scheduling your next appointment with your doctor.
MEDICAL EYE EXAM
A medical eye exam is designed specifically to look for conditions and diseases that result in poor eye health. When an eye doctor conducts a medical eye exam, they are looking for problems that can’t be corrected by glasses or contacts. Although a refraction can be a part of the comprehensive eye exam. Eye doctors use this as an additional diagnostic tool to note any changes in your overall eye health. Some of the medical problems that could be found during a medical eye exam include glaucoma, conjunctivitis, or cataracts. If you receive this type of diagnosis, your eye doctor will also treat the issue.
Sometimes it’s complicated for a patient to determine if they need a routine eye exam or a medical eye exam. It can get even more confusing to find out if your insurance will cover the exam. Please reach out to your insurance carrier to assist with your specific covered services.