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Eye Exam

Vision Exam vs. Medical Eye Exam

Terms like vision screening, routine, comprehensive, and medical eye exam may seem interchangeable, but there are notable differences in these exams, and insurance plans treat them differently. To simplify things, it’s better to think of your eye care benefits separately (vision or medical).

Vision Exam

A vision exam is focused on determining your prescription and identifying whether you need glasses or contact lenses. Along with your refraction, your doctor will make sure there are no medical issues and that your eyes are generally healthy. These exams allow your eye doctor to thoroughly analyze the health of your eye using a combination of tests. The specific tests your doctor performs will depend on your vision history and needs. Some common eye tests include (but are not limited to):

  • Visual acuity test to measure the sharpness of your vision at different distances
  • Visual field test to check for the presence of blind spots in your peripheral (side) vision
  • Dilated eye exam to widen the pupils allowing for a better view of the back of your eye
  • Cover test (cover one eye at a time) to check how well your eyes work together
  • Ocular motility test to determine how well your eyes can follow a moving object
  • Refraction test to determine your exact eyeglass prescription
  • Slit lamp exam to examine the structures of your eye under high magnification

Contact lens fittings typically do not occur at comprehensive eye exams, unless your current contacts were fitted by the same eye doctor who is performing your comprehensive eye exam.

Many eye and vision conditions present no obvious symptoms, which is why regular comprehensive eye exams are so important. The earlier an eye disease or condition is diagnosed, the more effective treatment is likely to be to help maintain clear, healthy vision.

Medical Eye Exam

During your vision exam, if your doctor discovers a medical condition, such as glaucoma, cataracts, diabetes, etc., you would require further testing and follow-up. The follow-up that results from a vision exam is a medical eye exam. It’s designed to evaluate or treat you for medical conditions that may affect you vision or resolve issues beyond those related to your eyeglass prescription. This exam focuses on further evaluation of your medical eye condition, additional testing, and a recommended treatment plan.

If you require a medical eye exam, you may need to be scheduled for a follow-up exam and possibly referred to a specialist.

Source: Coherent

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HealthTeam Advantage, a product of Care N’ Care Insurance Company of North Carolina, Inc., is a PPO and HMO Medicare Advantage plan with a Medicare contract. 
Enrollment in HealthTeam Advantage depends on contract renewal.

Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Every year, Medicare evaluates plans based on a 5-star rating system.

Page last updated: September 18, 2024

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