Vision coverage: Does Medicare cover eye exams?

 
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Having Medicare coverage opens many doors to healthcare services, but when it comes to your vision—from glasses to eye exams to cataract surgery—what you need may not always be covered.

Does Medicare cover vision care? 

Routine eye or vision care (including eyeglasses and contacts) is not covered by Medicare.1

If treatment may improve or cure chronic eye conditions like glaucoma or cataracts, and is viewed medically necessary by a Medicare-participating physician, Medicare may cover it. But you'll need to check with your doctor to see if your condition makes the cut. For example, Lasik surgery is not considered a medical necessity and will not be covered by Medicare.

Does Medicare cover eye exams?

A simple vision test is included in the “Welcome to Medicare” preventive visit. It is covered by Medicare Part B, but it is offered only once and within the first year of Part B coverage.2

Routine eye exams for eyeglasses or contact lenses are not covered. However, a yearly eye exam is covered by Medicare Part B for those living with diabetes and diabetic retinopathy. An eye doctor who is legally permitted to do testing in the state where you live must perform the exam. Eye exams for diagnostic purposes, such as testing for glaucoma or macular degeneration, may also be covered.3

You will have to pay 20% of the amount approved by Medicare for these services. Your Part B deductible will also apply. A copay will be charged if you get tested in a hospital outpatient setting.4

Does Medicare cover eyeglasses?

The simple answer is no: Medicare usually does not cover the cost of eyeglasses or contact lenses. However, if you need cataract surgery—during which an intraocular lens (IOL) is implanted—Medicare Part B will help cover the cost of 1 set of corrective lenses (either contacts or glasses). Also, the supplier must be Medicare-enrolled.5

Does Medicare cover the cost of cataract surgery?

Medicare does cover cataract surgery as a medically necessary surgery. You can work with your doctor and the hospital or facility where you’ll have the surgery to help estimate the costs. You’ll also want to determine whether the surgery will be inpatient or outpatient. This will impact what you pay. You can also sign in to MyMedicare.gov opens link in new window to check if you’ve met your deductible, which must happen before Medicare will start to pay.

How do I budget for vision care?

Start by having a conversation with your physician or healthcare provider about the costs of testing, services, glasses or contact lenses, and potential surgeries. Having a better understanding of cost will help you budget for these items.

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