What is A Refraction & Is It Covered By Insurance? Skip to main content

March 02, 2022

By: Jeffrey Martin, MD

What is a Refraction and Why is it Often Not Covered by a Patient’s Insurance

man receiving an eye exam by an ophthalmologist

For many people, an eye exam is a trip to the eye doctor (either an ophthalmologist or an optometrist) for a prescription for eyeglasses or contact lenses.

What is a Refraction Test?

A refraction test is usually given as part of a routine eye examination. It may also be called a vision test. This test tells your eye doctor exactly what prescription you need in your glasses or contact lenses.

Normally, a value of 20/20 is considered to be optimum, or perfect vision. Individuals who have 20/20 vision are able to read letters that are 3/8 of an inch tall from 20 feet away.

If you don’t have 20/20 vision, you have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of your eye. The refraction test will tell your doctor what prescription lens you should use in order to have 20/20 vision.

Why is this test used?

This test tells your doctor if you need prescription lenses, as well as what prescription lens you need to see properly. The results of the test are used to diagnose if a patient is suffering from astigmatism, farsightedness or nearsightedness. The results can even help diagnose more serious problems such as macular degeneration or retinal detachment.

The Cost of a Refraction

While a refraction is essential for a comprehensive eye exam, the charge for a refraction is only covered by some insurances but not all. Medicare does not cover refractions because the test is considered to be a part of a routine exam and not a medical need. Medicare does not cover most routine procedures, but rather health-related vision expenses.

Contact SightMD today to schedule an appointment with one of our doctors to discuss your vision health at one of our convenient locations!