Does Medicare Cover Eye Exams?

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Eye exams

Did you know that 44 million people in the United States are enrolled in the Medicare program? If you are new to the world of Medicare and are wondering "does Medicare cover eye exams?" we are here to clear things up.

Keep reading to learn more about what is covered and what you can expect to pay out of pocket for. 

Does Medicare Cover Eye Exams?

Original Medicare Part A and Part B will not cover routine eye exams for contact lenses or for eyeglasses. Part B will cover an annual eye exam every twelve months for those that are at high risk of glaucoma or for anyone that has diabetes. 

Part B will cover diagnostic tests and treatment for some eye diseases. These include ocular photodynamic therapy, aflibercept, and Lucentis. Unless you have a necessary cataract surgery, Plan B will not cover glasses or contact lenses.

It will also cover cataract surgery, treatments for macular degeneration, and prosthetic eyes. Keep in mind that you will have to pay a 20% coinsurance cost for most of these types of treatments. 

If you ever have a medical emergency involving your eyes then Medicare Part A will cover you. For example, if you are involved in an accident and your eyes are affected and they admit you to the hospital because of your eyes then your plan benefits will apply. 

Most people with Part A will opt to enroll in a private individual vision insurance plan to make sure they are covered. 

Medicare Advantage Plans

There are some Medicare Advantage plans that might cover routine eye exams at no extra cost. You can check on a reputable site like MedicareWire.com to see what options you have in your local area. 

Some Medicare Advantage plans will offer annual eye exams with a small copayment or coinsurance depending on the plan that you choose. You might also have to go see a specific doctor within their network depending on the Medicare Advantage plan you choose.

If you know that you will need prescription eye drops or other medications for a specific eye condition then you want to make sure that you choose a plan that includes Part D coverage. Part D will ensure that you also have coverage for prescription drugs. For those looking for a plan to cover their prescription eyeglasses and contact lenses then look at your options because there are some plans that will offer this at no cost or with a copayment. 

Feeling Like a Medicare Pro?

Now that we answered the question "does Medicare cover eye exams?" you can take a look at your current plan coverages and see what your plans cover. If you are in the process of enrolling in Medicare and are choosing the best plans for your needs, now you can make informed decisions on what to pick and choose. 

Did this blog post help you out today? Please feel free to browse the rest of our lifestyle section for some more informative and helpful reads. 

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