Medical Eye Exams, Routine Screenings, And Medicaid: What You Need To Know

What are medical eye exams—and are they different from routine vision checkups? Before you schedule your next office appointment, take a look at what you need to know about medical eye exam services. 

Are All Eye Exams the Same?

No, all eye exams are not the same. A medical exam is exactly what the name sounds like. This type of service includes an examination for and potentially a diagnosis of medical eye disorders or conditions. These could include glaucoma, cataracts, or infections. Some patients with chronic conditions, such as diabetes, may also need a medical exam to check their eye health. 

Even though an eye doctor can spot some medical issues during a routine exam, this type of service focuses on your vision. The eye doctor can diagnose common conditions, such as farsightedness, nearsightedness, or astigmatism. They can also recommend glasses or contact lenses and provide you with a new or updated prescription. 

How Do You Know Which Exam To Choose?

The answer to this question depends on your eye health, health history, exam history, and current symptoms. You may need a medical service if:

  • You have spots or halos. Glaucoma can cause you to have blind spots in patches and cataracts can cause halos when you look at lights.

  • You have vision changes that progress. Glaucoma and cataracts can cause blurred or cloudy vision that worsens over time. 

  • You have pain, irritation, or redness. An eye infection can cause discomfort, itching, redness (in the whites of the eye), tearing, or crusting of the eye.

  • You have vision loss. Complete or partial vision loss warrants a trip to the eye doctor for a medical exam and diagnosis.

  • You have diabetes. According to the U.S. Centers for Disease Control and Prevention (CDC), diabetes can cause retinopathy. If left untreated, diabetic retinopathy can lead to blurred vision, floaters, and vision loss.

  • You have a diagnosed eye issue. If you already have a diagnosed eye condition, the doctor will need to check your progress and assess the effectiveness of the treatment.

Patients who are in good health, have no symptoms, and have no history of eye disorders, may only need a routine screening. If you do have blurred vision or you already have glasses/contact lenses, you will also only need a routine exam. Before you schedule an appointment, ask the eye professional what type of service you will need.

Does Medicaid Pay For Eye Exams?

The answer to this question depends on the plan, your state's requirements, the eye doctor, and the service you need. Some plans will cover the cost of glasses and contact lenses, while others may only pay for medical services. Contact an eye doctor's office to learn more about what services are covered by your Medicaid plan.