As we age, eye care becomes increasingly important. Medicare provides coverage for certain eye exams and treatments, but it’s essential to understand what’s included and what’s not. Here’s a clear breakdown:

Eye Exams Covered by Original Medicare

Original Medicare covers eye exams for specific medical conditions but does not typically cover routine vision care such as glasses or contact lenses.

Glaucoma Tests

Medicare Part B covers annual glaucoma screenings for high-risk individuals:

• African Americans aged 50+
• Hispanics aged 65+
• Individuals with diabetes or a family history of glaucoma

Covered tests include:

• Visual acuity assessments
• Tonometry (eye pressure measurement)
• Optic nerve examinations
• Visual field testing

Diabetic Retinopathy Exams

Medicare Part B covers annual exams if you:

• Have diabetes
• Receive a referral from your primary care doctor or diabetes specialist
• Are at high risk due to a previous diagnosis
• Are pregnant with diabetes

Macular Degeneration Tests

Medicare Part B covers diagnostics and treatment for age-related macular degeneration (AMD), including retinal exams and imaging.

Cataract Surgery

Medicare Part B covers cataract surgery, including the intraocular lens (IOL) and necessary medical services. Post-surgery, Medicare also covers standard eyeglasses or contact lenses.

Routine Vision Care

Original Medicare generally does not cover routine eye exams, glasses, or contact lenses unless they’re needed post-cataract surgery.

Supplemental Coverage Options

Medicare Advantage Plans (Part C)

Most Medicare Advantage Plans offer routine vision coverage, including:

• Routine eye exams
• Eyeglasses or contact lenses
• Additional vision services such as glaucoma screenings and treatment

Each plan varies, so carefully review benefits before enrolling.

Medigap (Medicare Supplement Plans)

Medigap can help cover routine vision care, including:

• Routine eye exams
• Refraction tests for prescription lenses
• Discounts on eyeglasses and contact lenses

However, standard Medigap plans typically do not fully cover eyewear costs.

Secure Your Eye Health with Plan Medicare

Understanding your Medicare options for vision care ensures optimal eye health without unnecessary financial stress. Contact Plan Medicare for expert guidance in selecting the right coverage for your needs.

Call 516-900-7877 or Book an Appointment to secure comprehensive eye health coverage today!

Frequently Asked Questions

What Eye Exams Do Medicare Advantage Plans Cover?
Routine vision exams, comprehensive eye exams, and diagnostic tests for eye diseases.

Does Original Medicare Cover Eyeglasses or Contacts?
Only after cataract surgery; otherwise, no.

Are Routine Eye Exams Covered by Medicare Part B?
No, Part B covers only medically necessary exams like glaucoma or diabetic retinopathy screenings.

What Tests for Diabetic Retinopathy Are Covered?
Dilated eye exams, retinal imaging, and OCT scans.

What Does Medicare Part B Not Cover?
Routine vision exams, eyewear, and preventive eye services.