It is the responsibility of the patient to know his/her benefits. Most insurance plans will differentiate between a routine eye exam and a medical eye exam. You must decide if the reason you need an eye exam is because you have a specific complaint or just because you would like your eyes examined.

Any examination that takes place as a result of a patient's complaint or symptoms (ie: dry eyes, headaches, eye infection, etc.) would be considered medical in nature and should be covered under your medical insurance. Any eye exam conducted at the patient's request without a specific complaint would be considered routine. This type of exam would only be covered if your insurance contact specifically states routine eye coverage is a benefit.