Does Medicare cover annual eye exams?

Does Medicare cover annual eye exams? Medicare Part B does not cover routine annual eye exams, but it may cover them to monitor and diagnose other disorders, such as diabetes, glaucoma, cataracts, or eye injuries. Medicare Advantage may also offer vision insurance as an added benefit. Read more below about your Medicare vision coverage options.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Apr 28, 2021

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The Highlights

  • Medicare Part B does not cover annual eye exams or a pair of eyeglasses, but it may cover them if it’s related to other conditions.
  • Some Medicare Advantage plans include vision insurance as an added benefit.

If you currently wear glasses or contact lenses, you know that prescriptions often change over time. And if you don’t currently wear glasses or contact lenses, you may know that vision usually worsens with age.

But does Medicare cover annual eye exams? Medicare Part B generally does not cover annual eye exams, but they may cover them for reasons related to other disorders. Read more below to find out if Medicare will cover your vision care.

Always compare health insurance quotes from different companies to ensure you are getting into business with the right health insurance company for you.

If you need help finding a health insurance plan that is the right fit for you, enter your ZIP code below to start comparing quotes now.

Does Medicare cover annual eye exams?

Original Medicare does not cover annual routine eye exams at the doctor to gain a prescription for eyeglasses or contact lenses. However, Medicare Part B may cover eye exams for people to treat specific disorders. We’ll cover these a little later.

Some Medicare Advantage plans may include vision insurance as an extra benefit. You should contact your policyholder to find out if this is an option for you. Some Medigap plans may also offer this at an extra cost.

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When does Medicare cover eye exams?

Medicare Part B will cover an annual eye exam if you have diabetes to monitor the possibility of diabetic retinopathy. The test must be performed by a healthcare provider that is licensed in your state to conduct the test.

Medicare Part B may also cover an annual eye exam for those at risk for glaucoma if you have diabetes, have a family history of glaucoma, are an African American over the age of 50, and/or are Hispanic and over the age of 65.

Eye exams, along with diagnostic testing, doctor’s visits, and some prescription drugs, are covered by Medicare Part B if you have (or have symptoms of) macular degeneration.

Medicare will generally cover the charges for cataracts as well. If you have cataract surgery, any expenses related to a hospital stay will be covered by Medicare Part A, while outpatient treatment expenses will be covered by Medicare Part B. They may also cover glasses or contacts after your surgery if you have an intraocular lens implant.

If your eye is injured, Medicare will generally cover any exams or tests used to measure the extent of the injury, as long as they are medically necessary.

After you meet your health insurance deductible, Medicare will usually pay 80 percent of the cost.

What is the bottom line?

So, does Medicare cover annual vision exams? Original Medicare insurance products will not cover routine annual eye exams. However, Medicare Advantage may offer extra vision benefits, so you should contact your policyholder to ask for details.

Original Medicare may also cover eye exams for disorders, such as diabetes, glaucoma, cataracts, eye injuries, and other medically necessary eye condition reasons.

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References:

  1. https://www.medicare.gov/coverage/eye-exams-for-diabetes

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