What Is Refraction And Why Doesn’t Insurance Always Cover It?

A refraction is a test done by your eye doctor to determine if glasses will make you see better.

The charges for a refraction are covered by some insurances but not all.

For example, Medicare does not cover refractions because they consider it part of a “routine” exam and Medicare doesn’t cover most “routine” procedures - only health-related procedures.

So if you have a medical eye problem like cataracts, dry eyes or glaucoma then Medicare and most other health insurances will cover the medical portion of the eye exam but not the refraction.

Some people have both health insurance, which covers medical eye problems, and vision insurance, which covers “routine” eye care (no medical problems) such as refractions and eyeglasses.

If you come in for a routine exam with no medical eye problems or complaints and you have a vision plan then the refraction is usually covered by your vision insurance.

Article contributed by Dr. Brian Wnorowski, M.D.

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