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Medical vs. Vision Exams: The Differences

The Difference Between a Medical Eye Exam and a Vision Exam

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Vision Exam:

The Vision Exam is for patients who have NO eye disease or symptoms of disease. It is sometimes referred to as a “Routine Exam” or “Well-Vision Exam.” Routine Vision Exams do not qualify for prescribing medications and most often are not covered by medical insurance, alternatively a Vision Plan will be billed.

Your eyes will be examined for any needed correction either by glasses or contact lenses or for any potential indicators of eye disease. A Vision Exam may indicate that you need a Medical Exam but it does NOT substitute for a Comprehensive Medical Eye Exam. Yearly diabetic eye exams will not be billed to insurance under Vision Plans.

Medical Eye Exam:

The Comprehensive Medical Exam is for patients who have a current diagnosis and treatment of eye diseases and conditions of the eye performed by a physician/surgeon, therefore we will bill your medical insurance. A refraction, which is the determination of your eye glass prescription, is a necessary part of a Comprehensive Medical Exam but may NOT be covered under your medical insurance.

This exam evaluates the reasons for the symptoms and assesses any treatment needed. Some conditions evaluated with medical eye exams include Cataracts, Glaucoma, Diabetic Retinopathy, Macular Degeneration and many other potentially sight-threatening diseases.

Insurance coverage for eye exams varies. Some plans only cover Routine Vision Services, otherwise known as Well Visits. Other plans will not pay for your exam unless you have a medical eye condition or disease. Some plans require a referral from your primary care physician. Be sure to check your policy(s) to determine your coverage or ask one of our knowledgeable staff members.

Contact us at Eye Care Specialists today to schedule your Vision Exam or Medical Eye Exam at 781-769-888o.