Does Medicare Cover Eye Exams?

Original Medicare doesn't cover routine eye exams in most cases. But there are some exceptions and alternatives.

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Original Medicare (Part A and Part B) generally doesn't cover eye exams. It usually doesn't cover glasses or contact lenses either.
There are some exceptions. Medicare Part B may cover eye exams if you’re in a high-risk group for eye disease, for example.
You still can, and should, get eye exams while on Medicare. You can pay for them out of pocket or get private vision insurance. Also, many Medicare Advantage (Part C) plans offer vision coverage that includes eye exams.

When does Medicare cover vision exams?

Medicare Part B (part of Original Medicare) covers an eye exam only when a patient has a disease that can cause loss of vision or blindness, or is at risk for one of those diseases, such as glaucoma.

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Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
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Does Medicare cover eyeglasses or contact lenses?

Original Medicare doesn't cover corrective lenses in most cases. However, Medicare Part B may cover one pair of eyeglasses or contact lenses if needed after cataract surgery .
(If you want options beyond standard glasses, such as tinted lenses or scratch-resistant coating, you would pay any additional costs.)

Does Medicare cover eye exams for glaucoma?

You’re covered for one glaucoma test every 12 months by Medicare Part B if you’re considered at high risk for developing glaucoma. You’re high-risk, according to Medicare, if you have diabetes, there’s glaucoma in the family, you’re African American and 50 or older, or you’re Hispanic and 65 or older

Does Medicare cover diabetic eye exams?

If you have diabetes, Medicare Part B will cover one eye exam per year for diabetic retinopathy. Make sure you see an eye doctor who’s qualified to do the test

Does Medicare cover macular degeneration?

If you have age-related macular degeneration, you may be covered for some tests and treatment of eye conditions under Medicare Part B

Does Medigap cover eye exams?

Medigap, also known as Medicare Supplement Insurance, is private health insurance that covers certain out-of-pocket costs of Original Medicare, such as coinsurance and deductibles. Medigap typically doesn't cover routine eye exams for people not identified as high risk.

Does Medicare Advantage cover eye exams?

Medicare Advantage may cover eye exams, even when you’re not in a high-risk group. Medicare Advantage plans may also cover eyeglasses and contact lenses. Private insurers offer Medicare Advantage plans, and coverage can vary by plan. Check your plan information for coverage details.
Routine eye exams aren't considered a major medical expense. So, you don't want to base the decision between Medicare Advantage and Original Medicare on vision coverage alone.

How to get vision coverage on Medicare

Private vision insurance is a way to spread out some of the costs of eye exams, eyeglasses and contacts, and possibly save money. Vision plans from VSP Vision Care, one of the biggest vision insurers, start as low as $17 a month.
For some people, it may make sense to pay for eye exams out of pocket. Annual routine eye exams generally range in cost from around $50 to $200, depending on your location and the provider you see.
For people with low incomes, Medicaid in most states covers routine eye exams. Some states have copays, but they're usually small.
The American Academy of Ophthalmology’s EyeCare America program offers eligible people ages 65 and older an eye exam by a volunteer ophthalmologist, often with no out-of-pocket cost. You don't need a low income to qualify for this program .
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