Does Medicare Cover Routine Eye Exams and Glasses? — the Straight Answer

Generally no. Original Medicare does not cover routine eye exams for glasses or contacts, and it doesn't cover glasses themselves — with one exception: one pair after cataract surgery. Medical eye care, like glaucoma and diabetic eye exams, is covered.

What Original Medicare covers

Medicare draws a line between routine vision and medical eye care, and covers only the medical side. Part B covers a yearly glaucoma test if you are at high risk — people with diabetes, a family history of glaucoma, African Americans age 50 and older, and Hispanic Americans age 65 and older — a yearly diabetic retinopathy exam if you have diabetes, and diagnosis and treatment of eye diseases such as macular degeneration. Cataract surgery is covered too, and it triggers the one glasses exception: one pair of corrective eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens.

What it does NOT cover

Routine eye exams — the refraction that determines your prescription — plus eyeglasses and contact lenses in every other situation. A yearly "check my eyes and update my glasses" visit is yours to pay for.

The conditions and limits

The covered exams are tied to specific medical situations — diabetes, glaucoma risk, disease symptoms — not to age alone. If you booked the visit to get a new prescription, expect it to be billed as routine and not covered, even when the same office handles both kinds of visits. Ask how the visit will be billed when you schedule it.

What it costs you

For covered medical eye exams, you generally pay 20% of the Medicare-approved amount after the $283 Part B deductible, plus a facility copay in hospital outpatient settings. Routine exams, glasses, and contacts are 100% yours.

Many Medicare Advantage plans add a routine vision benefit — often an exam allowance and an eyewear allowance — with the specifics varying plan to plan in the Evidence of Coverage.

Doctor or advisor?

Sudden vision changes, flashes, floaters, eye pain, or anything connected to diabetes belongs with your doctor promptly — that is medical eye care, and it is covered. If routine vision benefits matter in how you receive your Medicare, weigh them with a licensed agent or a SHIP counselor — and weigh them honestly: an eyewear allowance is a real but modest benefit, not a reason by itself to pick a plan.