Routine eye care vs. Medical eye care

Medical Eye Exam

Eye exams for medical care are for a medical-related complaint or follow-up of an existing condition. These exams are billed to medical insurance. You may have an established medical condition that would necessitate your exam be considered a medical exam. The conditions include, but are not limited to:

  • Diabetes mellitus
  • Floaters and/or flashes of light
  • Glaucoma
  • High risk medication
  • Cataracts, post-cataract surgery
  • Eye muscles imbalance
  • Macular degeneration
  • Eye irritation
  • Dry eye
  • Other retinal issues
  • Foreign body
  • Eye injection

A refraction (glasses check) may be necessary during your medical eye exam. Medical insurance does not cover refraction.

Vision Plan & Routine Eye Exam

Most vision plans allow for 1 routine exam per year; they usually have an allowance for glasses and contacts and the fitting of contacts/glasses. Some medical insurance plans allow for 1 routine eye exam per year, and some cover the refraction and contact lens fitting. Vision plans do not cover medical treatment or follow-up. If a medical issue is found during your routine exam, a follow-up may be needed or, if urgent, the visit may be billed to your medical insurance.

If being seen for a medical reason, your exam will be billed to your medical insurance. Your Vision Plan (glasses exam) benefit can be used at a later date. You may also elect to pay the refraction fee and/or contact lens fitting fee out of pocket during your medical exam if you choose.

***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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Latest News

07.02.24

4th of July hours

All Tower Clock Eye Center offices will be closed on Thursday, July 4, to celebrate the holiday. We'll reopen on Friday with our normal schedule. We wish you all a happy and safe holiday!

06.13.24

Appleton surgery center update

Our Appleton surgery center is getting closer to opening its doors! We look forward to serving the Fox Cities with our patient-centered brand of ophthalmologic services! We look to open in late summer or early autumn.

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Green Bay, WI 54303

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Appleton, WI 54911

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