Routine eye care vs. Medical eye care

Medical Insurance

Routine/Preventative care: Some medical companies cover routine eye care. The patient must ask their insurance company if s/he has this benefit.

  • Limited exam to detect refractive error (nearsightedness, farsightedness, astigmatism), measure intraocular pressure, screen for risk factors for eye disease
  • Intended to evaluate general eye health
  • Does not cover treatment for eye diseases

Problem-related services: Billed to medical insurance

  • Treatment for new problems (i.e. infections, glaucoma, cataracts, macular degeneration, etc.)
  • Follow-up care for existing medical problems
  • Thorough examination of the external and internal structures of the eye
  • Diagnostic testing
  • Copays/deductibles may apply

We often do not know if the exam will be routine or problem-related until we discuss any symptoms you may be experiencing. If the type of exam changes at any point during the exam we will make our best effort to communicate this to the patient.

Vision Insurance

Vision coverage is designed to determine a prescription for glasses, help pay for glasses or contact lenses, and evaluate the health of the eyes. Vision insurance does not cover the evaluation and treatment of medical problems. If a medical condition is present the exam will need to be filed to your medical insurance provider.

***If you have any questions regarding insurance coverage or benefits, it is the patient’s responsibility to contact your insurance company.***

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