What Medicare Covers for Eye Care
Which eye exams, tests, surgery and glasses Original Medicare covers, from diabetic eye exams to cataract surgery, and what to ask before you go.
Original Medicare covers some eye care and leaves out a lot of it. The short version: routine exams for glasses and the glasses themselves are generally not covered, but exams and treatment for certain eye diseases are, along with cataract surgery. This guide walks through each benefit using Medicare's own pages, and explains what to ask the practice before an appointment.
Routine eye exams and glasses: generally not covered
Medicare says it does not cover routine eye exams for eyeglasses or contact lenses, so you pay the full cost of those under Original Medicare. It also does not cover eyeglasses or contact lenses in most cases. The main exception is after cataract surgery, described below.
Some Medicare Advantage Plans (Part C) offer vision benefits that Original Medicare does not, such as routine exams or an allowance for glasses. Benefits differ from plan to plan, so check your plan's documents or call the plan.
The one-time "Welcome to Medicare" preventive visit, available within the first 12 months you have Part B, includes a simple vision test. Medicare says you pay nothing for that visit if the provider accepts assignment. It is a screening, not a full eye exam.
Yearly eye exam if you have diabetes
If you have diabetes, Part B covers an eye exam for diabetic retinopathy once a year. Medicare says the exam must be done by an eye doctor who is legally allowed to do the test in your state. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the doctor's services, and in a hospital outpatient setting you also pay a copayment.
Glaucoma tests for people at high risk
Part B covers glaucoma tests once every 12 months for people at high risk. Medicare counts you as high risk if at least one of these applies:
- You have diabetes.
- You have a family history of glaucoma.
- You are African American and age 50 or older.
- You are Hispanic and age 65 or older.
An eye doctor who is legally allowed to do glaucoma tests in your state must do or supervise the screening. After the Part B deductible, you pay 20% of the Medicare-approved amount, plus a copayment in a hospital outpatient setting.
Macular degeneration
If you have age-related macular degeneration, Part B covers certain diagnostic tests and treatments, including treatment with certain injectable drugs. After the deductible, you pay 20% of the Medicare-approved amount for the drug and the doctor's services, with a separate facility copayment in a hospital outpatient department. Ask the practice which tests and drugs it plans to use and whether Medicare covers them in your case.
Cataract surgery
Part B covers cataract surgery that removes the cloudy natural lens and implants a conventional intraocular lens. Your share depends on where the surgery is done:
- In a hospital outpatient department or an ambulatory surgical center, you pay 20% of the Medicare-approved amount for the facility and the surgeon, after the Part B deductible.
- In a doctor's office, you pay 20% of the approved amount for the lens and the surgery to implant it, after the deductible.
Medicare's page describes coverage for conventional intraocular lenses. If a practice suggests a different type of lens, ask before surgery whether Medicare covers it and what you would pay out of pocket, and ask for the answer in writing.
Glasses or contacts after cataract surgery
After each cataract surgery that implants an intraocular lens, Part B helps pay for one pair of eyeglasses with standard frames, or one set of contact lenses. Medicare lists this under prosthetic devices. You pay 20% of the Medicare-approved amount after the deductible, and you pay the extra cost of upgraded frames. Medicare only pays for glasses or contacts from a supplier enrolled in Medicare, so check before you order.
What you pay: deductible, coinsurance and assignment
Most of the benefits above are subject to the Part B deductible, which is $283 in 2026, before Original Medicare starts to pay, and then 20% coinsurance. What you actually owe also depends on other insurance you have, where you get the service, and whether the provider accepts assignment.
Medicare explains that a provider who accepts assignment agrees to take the Medicare-approved amount as full payment, so you are charged only the deductible and coinsurance. A non-participating provider may accept assignment case by case and, in many cases, can charge up to 15% more than the approved amount. A provider who has opted out of Medicare is paid privately; Medicare will not pay for services from an opted-out provider except in emergencies.
Using this directory to prepare
Our listings are eye care organizations from the federal NPPES registry whose self-reported specialty is optometry or ophthalmology. Where we could match a practice to CMS's Doctors and Clinicians data, the listing shows whether the group is enrolled in Medicare and whether it accepts Medicare assignment. That information comes from federal data files and can lag behind changes, so confirm it with the practice when you book. We do not list prices or the vision plans a practice takes.
The type of eye doctor can matter. Medicare's diabetic eye exam and glaucoma test must be done by an eye doctor legally allowed to do them in your state, and cataract surgery is performed by a surgeon. Our guide to optometrists, ophthalmologists and opticians explains the differences and how to check a license.
Questions to ask before your visit
- Do you accept Medicare assignment for this visit or procedure?
- Will today's visit be billed as a routine vision exam, which Original Medicare does not cover, or as a medical exam?
- If I have a Medicare Advantage Plan, are you in its network, and does it include routine vision benefits?
- For cataract surgery: where will it be done, which lens is planned, and what will I owe if I choose a lens Medicare does not fully cover?
- After cataract surgery: is your optical shop, or the one you suggest, enrolled in Medicare as a supplier?
Medicare rules change, and the amounts above are for 2026. Check Medicare.gov for the current rules. If you have sudden vision loss or an eye injury, call 911 or go to an emergency department. This is general information about coverage, not medical advice.
General information only, current as of the date above. The information on Eye Doctor Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.