Does Medicare Cover Eye Exams?

If you're wondering whether Original Medicare covers routine eye exams, the short answer is no. Medicare Part A and Part B do not cover routine eye exams, eyeglasses, or contact lenses. If you just need a standard vision check to update your prescription, you will pay 100% of the cost out of pocket under Original Medicare.

However, there are important exceptions. Medicare does cover eye care when it is medically necessary to diagnose or treat a specific eye condition or disease. For example, if you have diabetes, Medicare Part B covers an annual eye exam to check for diabetic retinopathy. If you are at high risk for glaucoma, Medicare covers an annual glaucoma test. Medicare also covers certain diagnostic tests and treatments for macular degeneration.

If you need cataract surgery, Medicare Part B will cover the surgery and one pair of eyeglasses or contact lenses afterward. This is a specific, limited exception to the rule against covering glasses.

It's frustrating to realize that something as basic as seeing clearly isn't covered by the system you paid into for decades. But that's the reality of the paper promises. You need straight answers, no surprises, so you can plan accordingly.

Because Original Medicare leaves a gap when it comes to routine vision care, you have a choice to make. The Medicare module reminds us that there are two paths, not two products: Traditional Medicare (A+B) or Medicare Advantage (Part C).

If you stay on the Traditional Medicare path, you can purchase a standalone vision insurance policy to cover routine exams and glasses. A Medicare Supplement (Medigap) plan will not cover routine vision care, as it only pays the out-of-pocket costs for services that Medicare approves.

If you choose the Medicare Advantage path, many of these plans include extra benefits like routine vision, dental, and hearing coverage. But remember, you are trading the freedom of Traditional Medicare for a managed care network.

You shouldn't have to guess how to pay for your eye care. We can walk you through every option, whether that's adding a vision policy to your Traditional Medicare or comparing Advantage plans in your area.