Does Medicare Cover Eye Exams?

What vision services does Medicare cover?

Medicare is a federal health insurance program that provides coverage for people over the age of 65 and those with certain disabilities.

While Medicare does not cover all vision services, it does cover some vision-related services for people who meet certain criteria.

In this section, we will discuss the vision services that Medicare covers.

Yearly Eye Exam

Medicare Part B covers a yearly eye exam for people with diabetes to check for diabetic retinopathy, which is a common complication of diabetes that can lead to blindness. Medicare Part B also covers a glaucoma test once every 12 months for people at high risk for the disease.

Treatment for Eye Conditions

Medicare Part B covers treatment for some eye conditions, such as macular degeneration, cataracts, and dry eye syndrome. The specific treatments covered by Medicare may vary depending on the condition and the individual’s healthcare needs.

Diabetes

If someone has diabetes, their Part B will cover 80 percent of the medically necessary treatment amount. The individual will be responsible for 20 percent of the cost for treatment. 

Cataract Surgery

Part B will help you pay for corrective lenses if a patient had surgery to implant an intraocular lens. This includes coverage for corrective lenses with a pair of glasses or frames. You will be responsible for 20 percent of the cost. 

Macular Degeneration

Medicare will assist with the cost of particular diagnostic tests, and the cost of injected drugs as well. 

Glaucoma

Eye exams are covered 80% for glaucoma screenings which is covered under your part B. If you are high-risk for glaucoma or have a family history of glaucoma, your screenings will be covered every 12 months.

Corrective Lenses

Medicare does not cover the cost of routine eye exams or corrective lenses, such as glasses or contact lenses. However, Medicare does cover some of the cost of cataract surgery, which may include the cost of intraocular lenses that can improve vision.

Low Vision Devices

Medicare Part B may cover the cost of certain low vision devices, such as magnifying glasses or telescopes, for people with low vision. These devices can help people with low vision read, watch television, or perform other activities of daily living.

Emergency Eye Care

Medicare Part B also covers emergency eye care, such as treatment for a sudden onset of vision loss or other serious eye conditions that require immediate medical attention.

In conclusion, Medicare covers some vision-related services for people who meet certain criteria. Medicare Part B covers a yearly eye exam for people with diabetes, a glaucoma test for people at high risk for the disease, treatment for some eye conditions, low vision devices, and emergency eye care.

However, Medicare does not cover the cost of routine eye exams or corrective lenses.

If you have questions about your Medicare coverage for vision services, contact your healthcare provider or your Medicare plan.