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Routine Eye Exams

A routine eye exam is defined by insurance companies as an office visit for the purpose of checking vision, screening for eye disease, and/or updating eyeglasses or contact lens prescriptions. Routine eye exams will lead to a diagnosis such as nearsightedness, farsightedness, or astigmatism.

Vision insurance plans provide coverage for routine exams, glasses and contact lenses, or at least provide some type of discounts on your doctor’s fees. A routine eye exam is billed to your vision insurance plan. By law, Medicare does not pay for routine vision exams. See more about insurance here.

Medical Eye Exams

A medical eye exam produces a diagnosis, like conjunctivitis, dry eye, glaucoma or cataracts, to mention a few.

Depending on your policy, your medical insurance may cover a medical exam, but not pay for the exam if it is a routine eye exam. Examinations for medical eye care, assessment of an eye complaint, or to follow up on an existing medical condition are billed to your medical insurance plan. See more about insurance here.


A refraction is the part of the exam that determines your eyeglass prescription. It typically involves questions like, “which is clearer – option one or option two” as different lens combinations are shown to you.

Click here to learn about what to expect at your eye exam.

To read about 20 surprising health problems an eye exam can catch, click here.


Vision insurance policies will typically cover the eye exam and the refraction. However, medical insurance will not cover the cost of the refraction.

Insurance Questions?