Routine Eye Exam & Medical Eye Exam: What’s the Difference?

Routine Eye Exam & Medical Eye Exam: What’s the Difference?

To get the best possible eye care, you need a routine eye exam and a medical exam, but what’s the difference? Many patients just go for eye examinations but can’t tell the difference between the two. Both of these have the same processes, including refraction, intraocular pressure testing, dilation, and a personalized examination by a specialized eye professional such as an ophthalmologist or an optometrist. However, despite the numerous similarities, these processes also have some differences and patients need to know them so they can get the best out of their eye care and healthy routines. Before you schedule eye exams in Colorado Springs, below is the difference between a routine eye exam and a medical eye exam.

The primary difference between these two is that a routine eye exam involves diagnosis and treatment of simpler non-medical issues such as farsightedness or astigmatism whereas a medical eye exam involves the diagnosis and treatment of eye diseases such as cataracts, conjunctivitis or glaucoma. For instance, if you are visiting your doctor’s office because of blurry vision then you are going for a routine eye exam. On the other hand, if your reason for visiting your eye doctor is because you’re having a pink eye then that’s a medical exam. In addition, eyeglasses or contacts prescription and related issues are categorized under a routine eye exam.

However, if you are having a blurry vision due to cataracts and the doctor’s final medical diagnosis reveals cataracts, then that’s a medical eye exam. In simple terms, a medical exam, just as the name suggests, involves an examination due to an underlying medical condition whereas a routine exam deals with non-medical issues. Just remember that a routine eye exam can reveal a suspected medical condition that a doctor would have to perform a medical exam to confirm.

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Similarly, many people often want to know whether their insurance would cover their routine or medical eye exam. Well, depending on the type of exam you’re having, your insurance may or may not pay for it. Your eye doctor is expected to abide by healthcare guidelines when it comes to billing your insurance. In this regard, a medical exam is often billed to the patient’s medical insurance whereas a routine eye exam is billed to you (for self-pay) or your vision insurance (if you have one).

Since every insurance plan is different and processes billings differently, you as the patient should be educated regarding what your insurance will or will not cover when it comes to eye exams. Note that your eye doctor has no say regarding what your insurance can or cannot pay but asking questions can help you prepare for your eye examination ahead of time to avoid inconveniences. Ask your insurance as many questions as possible regarding what is covered or left out before you start going for eye exams.

Many people struggle with knowing the difference between a routine eye exam and a medical eye exam. Well, the simplest way to tell the difference is that a medical eye exam is concerned with medical problems whereas a routine eye exam assesses and treats non-medical eye problems. Also, do note that your insurance may cover a medical eye exam but not a routine exam unless you have specific insurance for that purpose.

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