Seeing the Difference between Routine and Medical Eye Exams:
Determining the difference between a routine eye exam and a medical eye exam can be difficult, especially when insurance comes into play. To make things easier for you, our patients, we have created this helpful “cheat sheet.”
Routine Eye Exam: The main purpose of a routine eye exam is to detect certain risks for vision problems, including refractive errors like nearsightedness, farsightedness, and astigmatism.
Routine exams focus on determining your prescription and identifying whether you need glasses or contact lenses. Along with determining your prescription, your eye care provider will evaluate the health of your eyes using a combination of tests and make sure there are no medical issues associated with your eyes.
Typically, routine eye exams are followed by a lens and frame fitting session. The frequency of routine exams is once per year or once every two years, depending on the vision insurance plan and the coverage you have. Your vision insurance, like VSP or EyeMed, would be used for these routine eye exams.
Medical Eye Exam: The main purpose of a medical eye exam is the diagnosis and treatment of an eye disease, like glaucoma, age-related macular degeneration, cataracts, or chronic systemic conditions such as diabetes.
These exams, also called comprehensive exams, are a more detailed and in-depth evaluation of your eye health and may even require additional testing during your visit. The frequency of a medical eye exam is determined by your Ophthalmologist. Your medical health insurance would be used during these exams.
If you have any questions about your specific insurance benefits and coverage regarding eye exams, the best way to find this out is by speaking with your insurance carrier.