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Traditional Medicare does not cover annual eye exams, vision testing, or routine testing from Ophthalmologists or Optometrists unless a patient is considered high risk for certain conditions, like glaucoma.
Seniors seeking vision coverage may consider enrolling in an optional Medicare Advantage plan, many of which cover vision testing and treatment.
Are you confused about what’s covered by Medicare? Dial (800) 950-0608 to speak with one of our available agents, or use our contact form to let us know if you’re interested in coverage for eye exams.
The risk of developing serious vision problems – including macular degeneration, cataracts, and glaucoma – increases as Americans grow older. The National Eye Institute recommends regular comprehensive dilated eye exams for adults age 50 and older.
While some groups of people, including those with diabetes or a family history of eye disease, are considered higher risk for developing eye disease than others, vision problems are not always the result of genetics or symptoms of a separate medical condition. Some common eye issues can be resolved or prevented with regular care, and routine eye exams are an important part of health maintenance for most seniors.
Traditional Medicare will cover routine eye exams from medical professionals only when certain conditions are met. If a senior is at high risk for developing eye disease or vision problems because they have diabetes, have a family history of glaucoma, or are a part of an ethnic group defined as high risk, they will receive partial coverage for routine eye exams related to those conditions.
For seniors who do not meet the above requirements, Medicare Part B does not cover routine eye exams. If you are concerned with monitoring your vision as you age and seeking out routine vision tests as a form of preventative healthcare, you will need to pay for testing and exam costs completely out of pocket.
However, there are other options for seniors without diabetes or a history of glaucoma who want to get coverage for eye exams. Optional Medicare Part C, or Medicare Advantage plans, often cover routine eye exams and other vision related health services. Enrolling in a Medicare Advantage plan that offers vision coverage is an excellent way for seniors who want to monitor their vision as they age – or who already wear glasses or contacts – to ensure they get the coverage they need.
Want to make sure you’re getting the vision coverage you need through Medicare? Our agents are available to answer your Medicare questions at (800) 950-0608.
Medicare Advantage plans must cover everything that Medicare Part A and Part B cover and generally offer additional benefits besides that, including eye exam coverage. When you enroll in a Medicare Advantage plan, you may have access to vision coverage, hearing coverage, and other benefits you wouldn’t get with traditional Medicare.
If you have questions about Medicare Advantage or want to learn more about Medicare in general, give us a call at (800) 950-0608. Our agents are available to guide you through the complicated process of choosing the right plan for you.