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

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

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

Answered by Brian Moore Medicare Insurance Agent

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

Answered by Melonie Wood on March 25, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent

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

Answered by Brian Krantz Medicare Insurance Agent

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, DE, FL & MD, NC, NJ & SC

Answered by Joseph Bachmeier Medicare Insurance Agent

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

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.

Answered by Robert Pennington on March 31, 2025

Broker Licensed in NC, GA, SC & VA

Answered by Robert Pennington Medicare Insurance Agent

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

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

Answered by William Lawler on March 28, 2025

Broker Licensed in MO, FL, IA & 12 other states

Answered by William Lawler Medicare Insurance Agent

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.

Answered by Bryan Smith on March 10, 2025

Broker Licensed in UT, AL, AR & 35 other states

Answered by Bryan Smith Medicare Insurance Agent

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.

Answered by Karen Boudreaux on March 13, 2025

Agent Licensed in TX, AZ, CA & 5 other states

Answered by Karen Boudreaux Medicare Insurance Agent

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

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

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”.

Answered by John Stagner on March 25, 2025

Broker Licensed in MO & TX

Answered by John Stagner Medicare Insurance Agent

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

Answered by Taylor Langlois Medicare Insurance Agent

Original Medicare does not cover eye exams. Depending upon the plan that you have, you may have a low or zero dollar cost for a yearly eye exam. Cataract surgery with a standard lens is a zero dollar cost And is covered by Medicare.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

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.

Answered by Leslie Helene Sussman on March 31, 2025

Broker Licensed in NJ, DE, FL & PA

Answered by Leslie Helene Sussman Medicare Insurance Agent

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

Answered by Tasha Riggs on March 27, 2025

Broker Licensed in CO, AZ, HI & 10 other states

Answered by Tasha Riggs Medicare Insurance Agent

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

Answered by Michael Pyers on March 26, 2025

Broker Licensed in OH & MI

Answered by Michael Pyers Medicare Insurance Agent

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

Answered by Ryan Raphael on March 5, 2025

Broker Licensed in MO, AZ, GA, IL & TN

Answered by Ryan Raphael Medicare Insurance Agent

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

Answered by Tammie Rutledge Medicare Insurance Agent

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

A Medicare Advantage plan covers dental, vision and hearing exams.

Best to ensure your choice of doctor(s) is covered under the plan

Answered by Jeffrey Simpson on March 7, 2025

Agent Licensed in NC, GA & SC

Answered by Jeffrey Simpson Medicare Insurance Agent

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.

Answered by Mitchell Jerome on March 12, 2025

Broker Licensed in TX

Answered by Mitchell Jerome Medicare Insurance Agent

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

Answered by Martin Cahill on March 4, 2025

Agent Licensed in MA, CT, FL & 5 other states

Answered by Martin Cahill Medicare Insurance Agent

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

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

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

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

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.

Answered by Jill Belvin on March 24, 2025

Agent Licensed in TX, AZ, FL, MI & NJ

Answered by Jill Belvin Medicare Insurance Agent

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.

Answered by Edward Cavelli on March 26, 2025

Agent Licensed in FL, OH, PA, TX, VA & WV

Answered by Edward Cavelli Medicare Insurance Agent

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

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