Medical vs. Routine Vision Exams: What’s the Difference?

Medical vs. Routine Vision Exams: What’s the Difference?

If you’ve ever wondered whether your eye appointment is considered a medical eye exam or a routine vision exam, you’re not alone—and it’s actually a really important distinction, especially when it comes to billing and insurance coverage.

What Is a Medical Eye Exam?

A medical eye exam focuses on your overall eye health and is typically used to diagnose, treat, or monitor medical eye conditions. These might include things like:

• Eye infections
• Dry eye or allergies
• Cataracts
• Glaucoma
• Diabetic retinopathy
• Blurry vision caused by a medical issue (not just needing glasses)

If you’re coming in with symptoms like eye pain, floaters, redness, or sudden changes in vision, your visit would likely be classified as medical—and it’s usually billed to your medical insurance.

Example:
🗨️ “I’m here because I’ve had eye pain and floaters for a few days.”

What Is a Routine Vision Exam?

A routine vision exam, on the other hand, is all about checking your visual acuity and updating your prescription for glasses or contacts. It’s more of a general wellness check for your eyes—perfect if you:

• Need a new glasses or contact lens prescription
• Want an annual checkup with no pressing eye health concerns
• Are due for a basic vision screening

Routine exams are typically billed to vision insurance.

Example:
🗨️ “I’m here for my yearly eye exam to update my glasses prescription.”

🔑 Key Takeaway

• Routine Vision Exam = Vision Correction
• Medical Eye Exam = Eye Health Issue or Monitoring

So next time you schedule an eye appointment, think about the reason behind your visit—it can make a big difference when it comes to your coverage and how your insurance processes the claim.

Still not sure which exam you need? Give us a call—we’re always happy to help clarify things and make sure you’re scheduled for the right kind of appointment.

📍 Tower Clock Eye Center proudly serves Green Bay, Appleton, and Shawano, providing both routine vision and medical eye care. Let our expert team help you see clearly and stay healthy – schedule at (920) 499-3102.