In most cases, the only way to get Medicare coverage for routine eye exams is through a Medicare Advantage plan. How can I get Medicare coverage for eye exams? Generally speaking, Medicare covers medically necessary eye exams to diagnose and treat any diseases or conditions of the eye, such as an eye infection or a foreign body in your eye. If your eyes are damaged in an accident or injury, Medicare usually pays for diagnostic eye exams and tests to determine the nature and extent of the injury. Does Medicare cover eye exams for eye injuries? If you have cataract surgery with an intraocular lens implant, Part B usually pays for one pair of prescription eyeglasses or contact lenses after your surgery. You’re responsible for the Part A deductible if your surgery requires a hospital stay, and your Part B deductible, plus your 20% coinsurance for covered outpatient services. Medicare typically pays allowable charges related to diagnosis and treatment of cataracts, including cataract surgery. Does Medicare cover eye exams for cataracts?
Part B generally covers allowable charges at 80% after your deductible is met. If you have macular degeneration, or your doctor suspects you do, Medicare Part B generally covers eye exams and tests to diagnose the disease, related doctor visits, and certain injectable drugs used to treat macular degeneration. Does Medicare cover eye exams for macular degeneration? You pay 20% of allowable charges after you meet your Part B deductible. Medicare Part B generally covers an annual glaucoma exam by a licensed eye doctor if you have any of the following risk factors for the disease: Does Medicare cover eye exams for glaucoma?
NEW TO MEDICARE? Learn what you need to know in 15 min or less. You need to see an eye doctor that accepts Medicare assignment to be covered. Part B does, however, cover eye exams and other eye tests under certain situations or if you have specific risk factors for disease. Unfortunately, under Original Medicare, there is generally no coverage for annual eye exams to check your vision and prescribe corrective glasses or contact lenses.
When most people ask, “does Medicare cover eye exams,” they’re referring to routine vision checks. This article explains how Medicare treats eye exams and coverage for conditions and diseases of the eye. According to the National Institutes of Health’s National Eye Institute, older adults are susceptible to age-related macular degeneration, cataracts, dry eyes, glaucoma, and low vision. Even if you currently don’t need prescription eyewear, there are a number of eye conditions that affect people as they age. If you wear glasses and have Original Medicare (Part A and Part B), the question “does Medicare cover eye exams” matters a lot.
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