Does Insurance Cover Eye Exams? (VSP, EyeMed, Medicare & More)

The short answer: usually yes  but which plan matters

Most people actually have two different kinds of coverage that can apply at the eye doctor: a vision plan and medical insurance. Which one pays for your visit depends on why you're being seen, and understanding the difference saves real money and confusion.  We would love to take all plan but they don't pay us fairly so we cannot.

Vision plans: for routine, healthy-eye visits

Vision plans like VSP, EyeMed, Davis Vision, Superior Vision, and Spectera cover routine annual exams. Checking your prescription and the health of your eyes when there's no medical problem. Not all plans cover the highly recommended retinal imaging. that can help your Dr catch early issues in the eye and body. We do not sell glasses or contact lenses in our office so we only look at your vision benefits for the exam, not materials.

Medical insurance: for eye problems and disease

When there's a medical reason for the visit such dry eye disease, diabetes monitoring, glaucoma, an eye infection, or a foreign body the visit patient pay out of pocket. At our office we only accept Medicare PPO for medical visits.

One important note: medical office visits like foreign body removal or eye infection treatment are not covered by vision plans, so those services are billed to medical insurance or paid out of pocket.

Common questions we hear

• "Can I use both plans at one visit?" No, usually we need to resolve the medical issue before proceeding to get the best vision for our patients.
• "What about Medicare?", Medicare doesn't cover routine exams, but it does cover medically necessary visits; we accept Medicare PPO.
• "What if I don't know what I have?", That's normal. Give us your insurance card when you book and we'll verify everything before you come in.

The easy way to handle it

You don't need to figure out which plan applies, that's our job. Call or book online, share your insurance information, and we'll verify your benefits and explain any costs before your appointment. No surprises at the front desk.