Medicare does not pay for preventative or routine eye care services like annual eye exams. If you have a long-term eye condition, like cataracts or glaucoma, Medicare will pay for some of your eye care. What Medicare Pays For:
- Surgical procedures to help repair the function of the eye due to chronic eye conditions. Surgery to remove a cataract and insert an artificial intraocular lens is one procedure that is covered by Medicare.
- Eyeglasses or contacts if you had an intraocular lens placed in your eye after cataract surgery. In this case, Medicare will cover a standard pair of untinted prescription eyeglasses or contacts if you need them. If it is medically necessary, Medicare may pay for customized eyeglasses or contact lenses.
- An eye exam to diagnose potential vision problems. If you are having vision problems that may indicate a serious eye condition, Medicare will cover an exam. Your exam is covered even if it turns out you do not have a vision problem.
Medicare will only pay for non-emergent eye care in the following cases:
- Medicare will pay for an annual eye exam by a state-licensed eye doctor for people with diabetes who are at risk for vision loss due to their condition.
- Medicare will pay for annual eye exams with a state-licensed eye doctor if you are at high risk for glaucoma. If you fit any of the following categories, you are at serious risk:
- Having diabetes
- Have a history of glaucoma in your family
- Are over the age of 50 and African-American
- Or, you’re a Hispanic American and 65 or older.
