Does Medicare cover eye exams?

Does Medicare cover routine eye exams?

No. Medicare doesn't cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses, and you pay all costs for them. Routine eye exams check for overall eye health and look for signs of vision problems or disease.

CMS's Medicare Benefit Policy Manual adds that eye refractions aren't covered, by whatever practitioner and for whatever purpose they're performed. The same manual says the exclusion doesn't apply to physicians' services performed in conjunction with an eye disease, for example glaucoma or cataracts.

Which eye exams does Medicare Part B cover?

Medicare Part B covers eye exams and tests for specific medical conditions:

• Eye exams for diabetic retinopathy: once a year, if you have diabetes. You must get the exam from an eye doctor who's legally allowed to do the test in your state.
• Glaucoma screenings: once every 12 months, if you have a high risk of developing glaucoma because at least one of these applies: you have diabetes, you have a family history of glaucoma, you're African American and 50 or older, or you're Hispanic and 65 or older. An eye doctor who's legally allowed to do glaucoma tests in your state must do or supervise the screening.
• Macular degeneration tests and treatment: Part B may cover certain diagnostic tests and treatments, including treatment with certain injectable drugs, if you have age-related macular degeneration.

What do I pay for a Medicare-covered eye exam?

For an eye exam for diabetic retinopathy or a glaucoma screening, you pay 20% of the Medicare-approved amount after you meet the Part B deductible ($283 in 2026), and in a hospital outpatient setting you also pay a copayment. For macular degeneration, in most cases you pay 20% of the Medicare-approved amount for the drug and your doctor's services after the Part B deductible, plus a separate facility copayment in a hospital outpatient setting.

The specific amount you owe also depends on other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility and where you get the service.

Does the “Welcome to Medicare” visit include a vision test?

Yes. During the one-time “Welcome to Medicare” preventive visit, your health care provider gives you a simple vision test. Medicare Part B covers the visit once within the first 12 months you have Part B, and you pay nothing for the visit if your provider accepts assignment; the Part B deductible doesn't apply. The visit isn't a comprehensive physical exam, and if your provider performs additional tests or services during the same visit that Medicare doesn't cover under this preventive benefit, you may have to pay coinsurance and the Part B deductible may apply. See Medicare and physical exams.

Can I see an optometrist for a Medicare-covered eye exam?

Yes, for covered services. CMS's Medicare Benefit Policy Manual says a doctor of optometry is considered a physician for all the services the optometrist is authorized to perform under state law or regulation, and the services must be medically reasonable and necessary for the diagnosis or treatment of illness or injury to be covered. For a diabetic eye exam or a glaucoma screening, the eye doctor must be legally allowed to do the test in your state.

Does Medicare Advantage or Medigap cover eye exams?

Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn't cover, like vision, so contact the plan for more information. Medicare Advantage plans must cover all medically necessary services that Original Medicare covers, and rules and costs vary by plan. Medigap (Medicare Supplement Insurance) plans generally don't cover vision care. For eyeglasses and contact lenses, see Medicare and glasses.