Eye insurance is confusing, but it doesn't have to be. Insurance has always been confusing, especially when it comes to eye exams. You may have routine eye exam coverage in addition to your medical insurance coverage.
Routine eye exam vs. Medical eye exam
How are they different?
Routine Eye Exam
Routine eye exam coverage is designed to pay toward a comprehensive eye exam that looks for but finds no medical problems.
Medical Eye Exam
Medical insurance pays toward eye exams that are medical in nature. Examples of medical visits include:
- Eye infection
- Dry eyes
- Loss of vision
- Eyelid stye
- Floaters
- Cataract
- Glaucoma
- Diabetes
What do they pay toward?
Routine Eye Exam
Routine coverage often pays for the exam and an eyeglasses prescription.
Medical Eye Exam
When there is a medical diagnosis like diabetes, cataracts or the examples above, we are required to submit the exam as medical, not routine. In most cases, a comprehensive exam that is medical in nature does not pay for an eyeglasses prescription. Deductible and coinsurance apply.