What Does Medicare Cover for Eye Exam Expenses?


Quick Answer

In most cases, Medicare Part A does not cover routine eye examinations, states the Center for Medicare & Medicaid Services. However, Medicare Part B may cover yearly eye examinations and testing for glaucoma and macular degeneration. Enrollment in Medicare Part B is optional, advises the AARP.

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Full Answer

If an individual has a chronic medical condition, certain eye exams and treatments may be covered, states Medicare Interactive. For example, if a person has a condition such as cataracts or glaucoma, treatments such as surgery to restore function of the eye may be covered. After a surgery that included the placement of an intraocular lens, Medicare covers prescription glasses or contacts if it is medically necessary. Medicare covers eye examinations if an individual is experiencing vision or eye symptoms that may indicate a serious condition.

Annual routine eye exams are only covered for individuals with diabetes to check for eye disease and those at high risk for glaucoma, states Medicare Interactive. Factors that qualify a person as high risk include a diagnosis of diabetes or a family history of glaucoma. African Americans over the age of 50 and Hispanics over the age of 65 are also considered high risk. For approved services to be covered, individuals must see a doctor who is accepted by Medicare.

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