Medical Insurance vs. Vision Insurance

Regular eye exams are important for maintaining good eye health and catching any eye problems early and it can be routine or diagnostic.  Routine care is typically covered by vision insurance.  Diagnostic eye care treats medical issues with your eyes and is typically covered by medical Insurance.  Having both types of coverage ensures that you will have assistance paying for your eye care.

 

What is Medical Insurance for your eyes?

Medical insurance covers the cost of things like doctor visits, tests, treatments, and procedures if you get injured or are diagnosed with a medical condition.  Medical insurance typically covers eye surgery (e.g. cataracts), or vision problems caused by medical conditions (e.g. glaucoma), which call for the diagnosis and treatment by an ophthalmologist.  These problems are classified as medical issues because you require a medical doctor to diagnose the problem, treat it, and prescribe medicine, but not necessarily vision-correcting devices like glasses or contacts.

 

What is Vision Insurance for your eyes?

Vision insurance helps pay for routine eye care and eyewear expenses. It can cover the cost of things like routine eye exams, contact lenses, and glasses.

 

Can I Use Medical Insurance for an Routine Eye Exam?

Eye exams are often considered preventative care and are included in some medical insurance plans. To find out if your medical insurance covers eye exams, you can look at your insurance plan’s summary of benefits or contact your insurance company.  Most of the time, if you are seeing an optometrist, they will bill vision insurance. If you are being seen by an ophthalmologist, they will likely bill medical insurance. 

 

Does Original Medicare cover routine eye exams?

No.  Routine vision is not covered by Medicare.  You can purchase a separate vision policy for this type of coverage.

 

Do Medicare Advantage plans cover routine eye exams?

Yes, most usually do even though Original Medicare doesn't cover these routine exams.  You can look at your insurance plan’s summary of benefits or contact your insurance company.

 

 This is a brief overview of the coverage that can be included in a Vision Insurance policy. You should read a policy thoroughly before purchasing any insurance policy.