If I don’t have a vision plan, does medical insurance cover eye exams?

In many cases, patients will find that their primary MEDICAL eye insurance plan will cover their visits. Medical plans do not cover “routine” annual examination. However, if you have eye problems that you are concerned about, your medical insurance plan may cover part, or even all, of your visit. Examples of medical eye problems include:

  • ocular allergies
  • dry eyes
  • eye pain
  • eye injuries
  • diseases that require eye examinations because the disease, or medications that you take to treat the disease) they can affect the eyes. Examples include diabetes, hypertension, auto-immune disease, thryoid disease, cancer, migraines, etc.
  • a history of eye diseases or eye injuries. For example, if a previous eye examination resulted in the doctor informing you that you are at risk for glaucoma, your eye examination will generally be covered via medical insurance as long as you inform us that you need an annual examination for monitoring glaucoma risk.