What is the Medicare coverage for eye care and eyeglasses?

Original Medicare

In most cases, Original Medicare does not cover eyeglasses or contacts. We discuss the exceptions below.

Medical Supplies Following Cataract Surgery

For individuals who have intraocular lens implants, Medicare Part B will partially cover the cost of corrective eyeglasses (standard frames only) or contact lenses. This includes coverage for eyeglasses or contact lenses if surgery took place before you were eligible for Medicare. Medicare may also pay for both lenses regardless of whether the surgery was only on one eye. After the deductible for Part B has been reached, an individual is responsible for 20% of approved amounts for the glasses or lenses. This applies to each cataract surgery.

Several things are required of eyewear suppliers:

They must have on file a prescription order signed by the ophthalmologist or optometrist.
They need to apply for and receive a Medicare supplier number. Strict requirements apply.
The eyewear supplier must be enrolled in Medicare and accept Medicare assignment to be considered a participating supplier.

Optometrist services following a cataracts surgery may be covered. The practitioner must be licensed by your state of residence.

Glaucoma Screening

Medicare Part B covers an annual glaucoma screening test for the following high-risk individuals:

those with diabetes
those with a family history of glaucoma
African Americans who are 50 or older
Hispanic Americans who are 65 or older

This screening may only be done by a licensed practitioner. After the deductible has been met, patients are required to pay 20% of Medicare-approved costs.

Routine Eye Exams

Generally, Medicare does not pay for routine eye exams. The following are exceptions:

glaucoma screenings
macular degeneration treatment

Macular Degeneration Treatment

Some treatment for macular degeneration is covered by Medicare Part B. This includes some injected drugs. After the deductible is met, individuals are responsible for 20% of the Medicare-approved costs.

Eye Prostheses

Medicare will pay for an eye prostheses for those who have either lost an eye or have eye shrinkage. This includes polishing of the eye and replacement every five years. After the deductible is met, individuals are responsible for 20% of the Medicare-approved amounts.

Medicare Advantage

Medicare Advantage plans must provide equivalent Original Medicare benefits. Many plans extend these benefits to include the following:

Preventive eye exams
Routine eye exams
Eyeglasses (frames and lenses)
Contact lenses

Need Help Finding a Medicare Plan?

For help finding a Medicare plan or Medicare Prescription Drug plan, try our Medicare Plan Finder. If you have any questions, please contact Medicare at any time at 1-800-MEDICARE (1-800-633-4227; TTY users 1-877-486-2048).

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