Does Medicare Cover Vision and Eye Exams?

Good vision is essential for daily life, independence, and safety as you age. According to the CDC, more than 7 million Americans live with some form of vision impairment, and the risk increases significantly after age 65. Yet many people are surprised to learn that Original Medicare provides very limited coverage for vision care.

This guide explains exactly what eye care services Medicare does and does not cover, how to get additional vision coverage, and what costs you can expect. Plans and coverage vary by location, so always check the details of plans available in your area.

What Vision Services Does Original Medicare Cover?

Original Medicare (Parts A and B) covers certain eye care services when they are medically necessary to diagnose or treat an eye disease or condition. These are considered medical services, not routine vision care. Medicare Part B generally covers the following:

Glaucoma Screening

Medicare Part B covers one glaucoma screening every 12 months for people at high risk. High-risk groups include people with diabetes, those with a family history of glaucoma, African Americans age 50 and older, and Hispanic Americans age 65 and older. The screening must be done by or supervised by an eye doctor legally authorized to perform it in your state. You typically pay 20% of the Medicare-approved amount after meeting the Part B deductible.

Diabetic Retinopathy Screening

If you have diabetes, Medicare Part B covers an annual dilated eye exam to check for diabetic retinopathy. This is an important screening because diabetic retinopathy is one of the leading causes of blindness in adults. Your eye doctor bills Medicare directly for this exam. You pay 20% of the Medicare-approved amount after the Part B deductible.

Macular Degeneration Treatment

Age-related macular degeneration (AMD) is a common eye condition among adults over 50. Medicare Part B covers diagnostic tests and treatments for macular degeneration, including certain injectable medications (such as anti-VEGF drugs) administered in a doctor's office. You generally pay 20% of the Medicare-approved amount.

Cataract Surgery and Post-Surgery Eyeglasses

Medicare Part B covers cataract surgery when it is medically necessary. About 20.5 million Americans have cataracts, according to available data, and surgery is one of the most common procedures performed on Medicare beneficiaries. After cataract surgery that implants an intraocular lens, Medicare also covers one pair of corrective lenses: either eyeglasses or contact lenses. You must get the lenses from a Medicare-enrolled supplier. This is the only situation where Original Medicare pays for eyeglasses.

What Vision Services Does Original Medicare NOT Cover?

Original Medicare does not cover most routine vision care. The following services are excluded:

• Routine eye exams for prescribing glasses or contact lenses
• Eyeglasses (except after cataract surgery as noted above)
• Contact lenses (except after cataract surgery)
• Eye refractions (the test that determines your prescription)
• LASIK or other refractive surgery

This gap in coverage can be significant. Eye care costs increased approximately 4.3% in 2024 according to the Bureau of Labor Statistics. A routine eye exam can cost $75 to $250 out of pocket, and a pair of prescription eyeglasses typically costs $200 to $600 without insurance.

Medicare Advantage Vision Benefits

Medicare Advantage (Part C) plans are the most common way Medicare beneficiaries get routine vision coverage. Many Medicare Advantage plans include vision benefits that go beyond what Original Medicare offers. For a detailed comparison of options, see our guide to the best vision insurance for seniors on Medicare.

Vision benefits in Medicare Advantage plans may include:

• Annual routine eye exams: Many plans cover one routine eye exam per year with a low copay or no copay at all.
• Eyewear allowance: Some plans provide an annual allowance, often between $100 and $300, that you can use toward eyeglasses, frames, lenses, or contact lenses.
• Lens upgrades: Some plans may cover upgrades such as progressive lenses, anti-reflective coatings, or photochromic lenses at discounted rates.

Not all Medicare Advantage plans include vision benefits, and among those that do, the level of coverage varies. Some plans provide only basic benefits like a routine exam, while others offer more generous allowances. Plans and coverage vary by location, so compare the options available in your area.

Standalone Vision Insurance for Medicare Beneficiaries

If you prefer to stay with Original Medicare, or if your Medicare Advantage plan does not include the level of vision coverage you need, you can purchase a standalone vision insurance plan. These plans are sold by private companies and are separate from Medicare.

Standalone vision plans typically offer:

• Annual comprehensive eye exams with a low copay (usually $10 to $25)
• An annual frame allowance of $100 to $200 or more
• Coverage or discounts for lenses and lens options
• Allowances for contact lenses as an alternative to glasses

Monthly premiums for standalone vision plans generally range from $10 to $30. These plans usually have no waiting periods, meaning coverage begins right away. Most use a network of providers, so you may pay less when you visit in-network eye doctors and retailers.

How Much Does Vision Care Cost Without Insurance?

Without vision coverage, you would pay the full cost of routine eye care services out of pocket. Here are some typical costs:

• Routine eye exam: $75 to $250
• Prescription eyeglasses: $200 to $600 for a basic pair with lenses and frames
• Progressive lenses: $150 to $500 additional
• Contact lenses (annual supply): $200 to $500
• Cataract surgery (per eye, after Medicare): $300 to $600 for the 20% coinsurance on the Medicare-approved amount

For seniors who need prescription eyeglasses and annual exams, these costs can add up to several hundred dollars per year. Vision insurance or a Medicare Advantage plan with vision benefits can help reduce these expenses.

Why Eye Care Is Important for Seniors

Vision problems become more common with age. About 20% of Americans over age 85 experience permanent vision loss that affects their daily activities. Common age-related eye conditions include cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy.

Regular eye exams can catch these conditions early, when treatment is most effective. Many eye diseases develop gradually without obvious symptoms. By the time you notice changes in your vision, the condition may have already progressed. An annual comprehensive eye exam is one of the most effective ways to protect your vision as you age.

Vision loss also increases the risk of falls, depression, and social isolation. Maintaining good vision is an important part of staying active, independent, and healthy in your later years.

How to Get Vision Coverage as a Medicare Beneficiary

You have several options for adding vision coverage to your Medicare benefits:

1. Switch to a Medicare Advantage plan with vision benefits: This is the most common option. You can enroll in or switch Medicare Advantage plans during the Annual Enrollment Period (October 15 to December 7) or the Open Enrollment Period (January 1 to March 31). Many Medicare Advantage plans include dental coverage too.
2. Buy a standalone vision plan: You can purchase a private vision insurance plan at any time. There are no enrollment periods for standalone vision plans. Premiums are typically $10 to $30 per month.
3. Check your Medicaid benefits: If you qualify for both Medicare and Medicaid, your state Medicaid program may cover routine eye exams and eyeglasses. Benefits vary by state.
4. Use community resources: Organizations like Lions Club International and state programs for the aging may offer free or low-cost eye exams and eyeglasses to seniors in need.

The Bottom Line

Original Medicare covers some important medical eye care services, including glaucoma screenings for high-risk individuals, diabetic retinopathy exams, macular degeneration treatment, and cataract surgery with one pair of post-surgical eyeglasses. However, it does not cover routine eye exams, eyeglasses, or contact lenses outside of these specific medical situations.

If routine vision care is important to you, consider a Medicare Advantage plan that includes vision benefits or a standalone vision insurance plan. Both options can help reduce your out-of-pocket costs for exams and eyewear.

Plans and coverage vary by location. This article is for educational purposes and does not constitute individual advice. Contact a licensed insurance agent or visit Medicare.gov to explore the specific plans available to you.