Do You Need Insurance to Get an Eye Exam?

iQuanti: You don't need insurance to get an eye exam, but you will have to pay out of pocket to cover the cost. However, certain types of medical insurance cover a portion of the cost of eye care exams and other vision treatments. There are also vision insurance policies that focus exclusively on eye care coverage.

What Is Vision Insurance?

Vision coverage acts as a supplement to your medical insurance policy. Typically, vision coverage includes annual eye exams. It can provide coverage for eyeglasses and contact lenses, too. A comprehensive vision insurance plan can even offer discounts on vision correction surgeries like LASIK.

How Does Vision Insurance Differ from a Standard Medical Insurance Policy?

Vision insurance is a wellness benefit. It gives you access to routine eye care exams and other vision services, at a fraction of the out-of-pocket cost.

A standard medical insurance policy covers eye care required following injury or disease. For example, consider what can happen if you need a medical eye exam due to an eye infection. If you have a standard medical insurance plan, your policy may cover a portion of the eye exam costs and any associated treatments. However, medical insurance typically doesn't cover routine eye exams or any corrective lenses.

What Is a Routine Eye Exam?

A routine eye exam can be used to diagnose nearsightedness, astigmatism, or other eye conditions that impact your vision. The exam is generally not covered under a standard medical insurance policy. Instead, it's usually covered by vision insurance.

During a routine eye exam, a doctor evaluates your vision. The doctor also checks your eyes for any signs of disease and may dilate your eyes to view the health of your entire eye.

Without vision insurance, a routine eye exam can cost anywhere from $50 to $250. If you have vision coverage, you're only required to pay the cost of your co-pay, which may range from $10 to $40.

What Is a Medical Eye Exam?

A medical eye exam is used to provide a diagnosis that indicates if you are dealing with a condition that hampers your eye health. Cataracts and glaucoma are two eye conditions that can be diagnosed during this type of exam.

Medical insurance will cover an eye exam if you are dealing with or may be dealing with an eye health issue. Coverage varies based on the health insurance plan, and unfortunately, it may be hard to know if your eye exam is medically necessary before the exam takes place. A routine eye exam that ends with a diagnosis of glaucoma is considered a medical exam, while a routine eye exam with no diagnosis isn't.

Should You Buy Vision Insurance?

Vision insurance offers a great investment to protect your vision. You can use vision insurance to save money on basic preventive eye exams. The insurance can even provide savings on eyeglass frames and lenses, contact lenses, and LASIK.

Meanwhile, the cost of vision insurance is unlikely to make a major dent in your budget. Vision insurance tends to have low premiums when compared to medical and dental insurance, making it a worthwhile investment in your ocular health.