Does Medicare cover eye exams, or are seniors left paying too much?

Question

Renee Brown · Accepted Answer

Original Medicare (Parts A and B) doesn't cover routine eye exams for glasses or contact lenses, it does cover certain eye exams and treatments related to specific conditions like glaucoma, diabetic eye disease, and macular degeneration, as well as cataract surgery. Some Medicare Advantage plans do however give the extra benefit of eye exams and glasses.

Answered by Renee Brown on March 25, 2025

Broker Licensed in FL, AL, AR & 32 other states

Answered by Renee Brown Medicare Insurance Agent

Melonie Wood · Answer

Most Medicare Advantage Plans DO have eye/dental/OTC/Travel/....  Orginal Medicare does not include vision/dental/OTC

Brian Moore · Answer

Medicare doesn’t cover routine eye exams for glasses or contacts under Original Medicare—seniors pay 100% out of pocket for those, and I’ve seen plenty frustrated by the cost when they just need a basic checkup. Part B does cover exams for specific conditions like glaucoma or diabetic retinopathy if you’re at risk, but that’s it unless you’ve got a Medicare Advantage plan with vision benefits tacked on. A major snag with Advantage plans, though, is that even with vision, dental, and hearing perks, the networks for those extras can be limited, making access trickier than people expect.

Answered by Brian Moore on March 26, 2025

Broker Licensed in OH

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William Lawler · Answer

Original Medicare does not pay for eye exams, but a Medicare advantage plan does pay for eye exams, usually at $0.

Joseph Bachmeier · Answer

Original Medicare will cover glaucoma eye exams because that is considered a medical condition . Original Medicare does not cover routine eye exams. Some Medicare Advantage plans will cover routine eye exams.

Answered by Joseph Bachmeier on March 25, 2025

Agent Licensed in PA, AZ, DE & 5 other states

Answered by Joseph Bachmeier Medicare Insurance Agent

Nikki Rowland · Answer

It all depends on the type of plan you have what what the exam is for.  If its vision and you need glasses, some plans have Vision built into them. Others you have to pay extra for the plan.

If it is for a medical purpose such as glaucoma screening, typically anything preventative will be covered.

Christopher Boyd · Answer

Cataract surgery and other intraocular eye treatments or eye surgeries are covered standard to plan deductibles and copays and varies between Medicare Supplement and Medicare Advantage. In 2025, Original Medicare will not pay for routine optometry with the exception of one set of glasses following cataract surgery. Medicare Advantage plans can offer some optometry coverage but that coverage and limits are set each year by the private insurance company. Although some MAPD/MA plans cover some glasses coverage, there are limits. Thus, the senior could still pay $200 to $400 or more for higher costs options on their glasses after the MAPD pays some of the costs.

Answered by Christopher Boyd on March 4, 2025

Agent Licensed in IN, KY, MI, OH, PA & TN

Answered by Christopher Boyd Medicare Insurance Agent

Robert Pennington · Answer

Medicare Supplements do not cover eye exams and would require a separate Plan to cover eye exams.  A Medicare Advantage Plan covers Dental, Vision, and Hearing.

Dutch VanHoesen · Answer

Medicare covers vision only when medically necessary such as cataracts. Routine vision, hearing and dental is not covered by Medicare. However many Medicare Advantage plans do include some coverage for vision. There are also ancillary vision discount or savings plans available.

Answered by Dutch VanHoesen on March 25, 2025

Broker Licensed in FL

Answered by Dutch VanHoesen Medicare Insurance Agent

Amy Putrino · Answer

It depends on your coverage. Original Medicare, your red, white and blue card, does not cover routine vision exams. If you are enrolled in a Medicare Advantage plan, then you may have cover for some of the things Original Medicare does not cover. This could included vision, dental and hearing.

Answered by Amy Putrino on March 25, 2025

Agent Licensed in RI, CT, FL & 11 other states

Answered by Amy Putrino Medicare Insurance Agent

Bryan Smith · Answer

Medicare doesn’t cover eye checkups for glasses, so seniors pay for them unless they have a special plan. It helps with eye tests only for bigger health problems.

John Stagner · Answer

Two things to know:

1. Medicare covers eye exams once per year to check for diabetic retinopathy if you have diabetes. It’s covered under part B, so you pay 20% after you’ve met the Part B deductible. In 2025, that deductible is $257.

2. Routine eye exams are not covered by Medicare. If your vision is simply getting worse due to age, it’s not covered.

However, Medicare DOES normally cover cataract surgery and one pair of glasses afterward. It has to be cataract surgery that implants an “intraocular lens”.

Karen Boudreaux · Answer

Yes Medicare pays if you go to an ophthalmologist. If you have a Medicare advantage plan, there is coverage as well with a co-pay and they usually give you money towards frames and lenses as well.

Taylor Langlois · Answer

Unfortunately Uncle Sam forgot to include your eyes, ears, and teeth with Medicare. There are instances where Medicare covers eye exams, but they have to be tied to specific medical conditions like annual glaucoma screenings for high-risk folks, cataract surgery, or exams for diabetic retinopathy. Thankfully there is vision coverage for pretty much any instance you find yourself in with Medicare.

Answered by Taylor Langlois on March 12, 2025

Agent Licensed in KS, CO, MO, NE, OK & TX

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Gregg Matheny · Answer

Original Medicare does not cover eye exams. However, if you replace Original Medicare and choose a Medicare Advantage Plan (Part C), a lot of these plans can cover eye exams and possibly more.

Answered by George Kolitsas on March 25, 2025

Broker Licensed in CT

Answered by George Kolitsas Medicare Insurance Agent

Leslie Helene Sussman · Answer

Original Medicare does NOT cover Eye exams.  Refer to page 12 in your Medicare and You Handbook 2025.      Most Medicare Advantage plans have a Vision benefit that covers a basic eye exam and most times an allowance for Vision wear.      Those clients on Medigap/Supplement plans can add on a Standalone Vision plan. 

Any questions on this benefit please contact me for more information.

Tasha Riggs · Answer

Medicare supplemental or original Medicare is Only health
Medicare Advantages have all the extra bells and whistles. Most of them have Eye wear coverage. 
If the Eye exam is for a medical reason it will be covered under all plans

Michael Pyers · Answer

Medicare covers medical procedures for your eyes.  However, Medicare does not cover routine eye exams.  Usually in this area $40-50

Michael Yost · Answer

Medicare does not usually cover routine eye exams. However, there may be exceptions that they would cover (Medicare would cover an eye exam after cataract surgery).

Tammie Rutledge · Answer

Original Medicare does not cover routine eye exams. If the exam is due to a health condition such as diabetes, it will be billed under Health Insurance. Typically, Medicare Advantage plans cover a routine eye exam with a $0 copay.

Answered by Tammie Rutledge on March 29, 2025

Broker Licensed in WA, AZ, FL & ID, MT, OR & TX

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Lea Ayres · Answer

While Original Medicare (Parts A & B) doesn't cover routine eye exams for glasses or contact lenses, it does cover certain exams and treatments for medically necessary conditions like cataracts, glaucoma, and diabetic retinopathy. Medicare Advantage plans, which are an alternative to Original Medicare, often include vision coverage, including eye exams.

Answered by Lea Ayres on March 12, 2025

Broker Licensed in PA, CT, MD & 8 other states

Answered by Lea Ayres Medicare Insurance Agent

Comfort Olude · Answer

Original Medicare does not cover routine eye exams for glasses or contact lenses. Medicare Part B may cover certain eye exams related to the diagnosis of glaucoma, diabetic retinopathy, and cataract surgery.
Medicare Advantage plans (Part C) may offer additional vision coverage, including eye exams or glasses, but you'll likely have a deductible/coinsurance out-of-pocket payment.

Ryan Raphael · Answer

The only time Medicare covers eye exams is if it's a medical necessity. Regular eye exams are not covered by original Medicare.

George Kolitsas · Answer

Original Medicare does not cover eye exams. However, if you replace Original Medicare and choose a Medicare Advantage Plan (Part C), a lot of these plans can cover eye exams and possibly more.

Jeffrey Simpson · Answer

A Medicare Advantage plan covers dental, vision and hearing exams.
Best to ensure your choice of doctor(s) is covered under the plan

Mitchell Jerome · Answer

Yes eye exams are covered and so are diseases of the eye.  Best to have a Supplement or Advantage plan thereby having full coverages without gaps.

Morgan Greer · Answer

Technically speaking, no, Medicare doesn't cover eye exams. Medicare covers Hospital and Medical costs only. However, there are ways to get eye exams and other health needs covered, and I'd be happy to discuss what options you have.

Answered by Morgan Greer on March 25, 2025

Agent Licensed in KS & MO

Answered by Morgan Greer Medicare Insurance Agent

Martin Cahill · Answer

Yes medicare advantage plans cover eye exams.  Medicare A&B do not.... Even with supplements need eye coverage

Amy Chamberlain · Answer

Medicare does not cover any routine dental or vision. Would need to purchase a separate plan or enroll into a Medicare Advantage plan Part C of Medicare where they could have some coverage for these benefits.

Answered by Amy Chamberlain on March 25, 2025

Agent Licensed in MI & WI

Answered by Amy Chamberlain Medicare Insurance Agent

Stephanie Yarberough · Answer

Medicare does not cover routine eye exams, but it does depend on the coding that the medical facility bills. If there is something in the exam medically based, that can be covered by Medicare. Glasses or contacts are not covered by Medicare except for a basic pair of glasses after approved cataract surgery. Many people will choose to add on vision insurance to help cover the costs Medicare does not.

Answered by Stephanie Yarberough on March 4, 2025

Broker Licensed in PA

Answered by Stephanie Yarberough Medicare Insurance Agent

Fred Manas · Answer

No, original Medicare (Parts A & B) typically does not cover routine eye exams for glasses or contact lenses. However, Medicare does cover certain vision care services, particularly if you have a specific eye condition like diabetes, glaucoma, or macular degeneration, or if you're at high risk for these conditions. Some Medicare Advantage plans (Part C) may offer additional vision benefits, including routine eye exams. 
Elaboration:
Original Medicare (Part A & B) Coverage:
.
Original Medicare, which includes Parts A and B, generally does not cover routine eye exams for the purpose of obtaining glasses or contact lenses. This means that if you need a routine eye exam to update your prescription, you will likely need to pay for it out-of-pocket. 
Medicare Coverage for Certain Conditions:
.
Medicare does cover vision care services related to the diagnosis and treatment of specific eye conditions or if you are at high risk for developing such conditions. For example, Medicare covers annual eye exams for people with diabetes to check for diabetic retinopathy, and it covers annual glaucoma screenings for people at high risk for glaucoma. 
Medicare Advantage Plans:
.
Medicare Advantage plans (Part C), which are offered by private insurance companies, may offer additional benefits beyond Original Medicare, including vision care. Some Medicare Advantage plans may cover routine eye exams and eyeglasses or contact lenses. 
High-Risk Groups:
.
If you are part of a high-risk group for certain eye conditions (e.g., family history of glaucoma, diabetes), Medicare may cover certain eye exams or screenings related to those conditions. 
Costs:
.
If you are not covered by Medicare for a routine eye exam, the cost can range from $170 to $200, on average. 
In summary, while Medicare does not cover routine vision care, it does cover vision care for specific conditions and may offer additional coverage through Medicare Advantage plans.

Sam Silva · Answer

Not covered by Original Medicare (Parts A & B).  Eyeglasses and Contact Lenses: Not covered unless you recently had cataract surgery.  

Medically Necessary Eye Exams:
Covered by Original Medicare if related to a medical condition, such as: Diabetes (diabetic retinopathy screening: once per year), Glaucoma (high-risk patients: once per year), Age-related macular degeneration, Eye injuries or infections.

Brian Krantz · Answer

Medicare doesn’t cover routine eye exams for glasses or contacts. It only covers eye care related to medical issues like glaucoma or cataracts. So yes, many seniors end up paying out of pocket for vision care unless they have extra coverage.

Answered by Brian Krantz on March 25, 2025

Broker Licensed in NY, AK, AL & 48 other states

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Aisha Saleem · Answer

Medicare Part B covers Glaucoma screenings for those who are high risk, along with eye exams related to specific eye conditions. However, routine eye exams for glasses or contacts are not covered. You may need to purchase supplemental insurance or pay out of pocket for some services. It's important to go over all your options while making decisions regarding your Medicare.

Answered by Aisha Saleem on March 13, 2025

Agent Licensed in MD & FL

Answered by Aisha Saleem Medicare Insurance Agent

Barbara Barnes, CMIP® · Answer

Eye health is important. Many medical conditions can be found through a comprehensive eye exam. So how much is that worth?

Medicare usually covers the part of your eye exam that looks for medical eye problems like cataracts, retinopathy, macular degeneration or glaucoma. Medicare does not pay for the vision refraction part of the exam for glasses or contact lenses. If you need treatment for a medical condition of the eye, Medicare will pay for that, too, but they usually do not pay for glasses or contact lenses.

Jill Belvin · Answer

Traditional Medicare does not cover eye exams, however some Medicare Advantage plans do cover this. Stand-alone vision coverage can be added for a minimal fee to help with this expense.

Edward Cavelli · Answer

Medicare itself does not cover eye exams. However Medicare advantage plans or Part C often does cover eye exams.

Supplements, original Medicare and Medigap can have standalone Vision, dental and hearing policies added at an additional cost if needed.