If you're experiencing vision changes or need reading glasses, you're probably wondering what Medicare covers. More than 12 million Americans over age 65 have vision impairment, and regular eye exams are crucial for detecting serious conditions like glaucoma, diabetic retinopathy, and macular degeneration. The answer to whether Medicare covers eye exams is complex—it depends on why you need the exam and what specific Medicare coverage you have.

This guide explains everything you need to know about Medicare coverage for eye exams in 2026. We'll break down what's covered, what you'll pay, and how to get the vision care you need without breaking the bank.

Medicare covers certain eye exams but not routine vision care. Understanding the difference is key to knowing what benefits you can access and what you'll need to pay for out-of-pocket.

Medicare divides eye care into two categories: medical eye care and routine vision care. Medical eye exams address specific health conditions or symptoms and fall under Medicare Part B. Routine vision exams for prescribing glasses or contact lenses generally aren't covered by Original Medicare, though Medicare Advantage plans often include this benefit.

Medical Eye Exams Covered by Medicare

Medicare Part B covers medically necessary eye exams when you have symptoms of eye disease or certain chronic conditions that increase your risk. These covered exams include:

Diabetic retinopathy screening. If you have diabetes, Medicare covers one dilated eye exam per year to check for diabetic retinopathy, a leading cause of blindness in adults. Your eye doctor will examine your retinas for damage caused by high blood sugar. Early detection can prevent vision loss, making this annual screening invaluable for diabetics.

Glaucoma screening. Medicare covers annual glaucoma tests if you're at high risk. You qualify as high-risk if you have diabetes, a family history of glaucoma, are African American and over 50, or Hispanic American and over 65. The screening measures eye pressure and checks for optic nerve damage that could indicate glaucoma.

Age-related macular degeneration (AMD) screening. If you're showing symptoms of AMD—like distorted central vision or difficulty reading—Medicare covers diagnostic eye exams. Your doctor will examine your macula for signs of deterioration and may order imaging tests like optical coherence tomography (OCT).

Medical eye problems. Medicare covers exams to diagnose and treat eye injuries, infections, or sudden vision changes. This includes conditions like conjunctivitis (pink eye), corneal abrasions, foreign objects in the eye, or sudden vision loss. These symptomatic exams fall under standard Part B coverage.

According to Medicare.gov, all medically necessary eye exams require a doctor's order and must be performed by a Medicare-approved ophthalmologist or optometrist.

Routine Eye Exams Not Covered by Medicare

Original Medicare doesn't cover routine eye exams for prescribing corrective lenses. This means if you simply need to update your glasses or contact lens prescription without any underlying medical condition, you'll pay the full cost yourself.

Routine vision exams typically cost between $50 and $250 depending on your location and the complexity of the exam. Many optometry offices offer package deals that include the exam and discounts on frames and lenses.

What Parts of Medicare Cover Eye Exams?

Understanding which Medicare part covers specific eye services helps you anticipate costs and plan your vision care effectively.

Medicare Part A Coverage

Medicare Part A doesn't typically cover eye exams since they're outpatient services. However, Part A does cover inpatient eye surgery if you need to stay in the hospital, which is rare for routine eye procedures. If you develop serious eye complications requiring hospitalization—such as severe infections or injuries—Part A would cover your hospital stay.

Medicare Part B Coverage

Medicare Part B is where most eye exam coverage exists. Part B covers medically necessary eye exams and certain diagnostic tests when ordered by your doctor.

For 2026, Part B charges a monthly premium of $192.10 and an annual deductible of $240. After meeting your deductible, you'll pay 20% coinsurance for covered eye services. A diabetic retinopathy screening that costs $150 would leave you paying $30 after your deductible is met.

Part B also covers diagnostic tests beyond the exam itself. If your doctor suspects glaucoma or macular degeneration, Medicare covers tests like visual field examinations, OCT imaging, and fluorescein angiography when medically necessary.

Medicare Advantage (Part C) Coverage

Medicare Advantage plans must cover everything Original Medicare does, but most go further by adding routine vision benefits. Approximately 90% of Medicare Advantage plans include some level of vision coverage.

Typical Medicare Advantage vision benefits include:

• One routine eye exam per year

• Allowance toward eyeglasses or contact lenses (usually $100-$300)

• Discounts on additional pairs of glasses

• Coverage for routine refractions (determining your prescription)

The catch? You must use in-network providers. Many plans partner with retail optical chains like Walmart Vision Centers, Costco Optical, or LensCrafters. Check your plan's provider directory before scheduling appointments.

Medicare Part D Coverage

Medicare Part D covers prescription eye drops and medications related to eye conditions. This includes glaucoma drops, antibiotic eye drops for infections, anti-inflammatory medications after eye surgery, and medications for dry eye syndrome.

Each Part D plan has its own formulary, so check that your prescribed eye medications are covered. Generic versions of common glaucoma medications like latanoprost or timolol are typically covered on all formularies with low copayments.

Understanding Your Costs for Eye Exams in 2026

Your out-of-pocket costs for eye care depend on which Medicare coverage you have and what type of exam you need.

Original Medicare Costs

With Original Medicare, here's what you'll pay for covered eye services in 2026:

Part B deductible: $240 annually. This applies to all Part B services, not just eye care. Once met, you won't pay it again until the next calendar year.

Coinsurance: 20% of the Medicare-approved amount for covered services. For a $150 diabetic retinopathy screening, you'd pay $30. For a more complex eye exam costing $300, you'd pay $60.

Routine exams: 100% of costs since Original Medicare doesn't cover them. Expect to pay $50-$250 per exam depending on your provider and location.

Prescription eyewear: Medicare doesn't cover routine glasses or contacts, so you'll pay full retail price. Glasses typically cost $200-$600 depending on lens type and frames. Contact lenses run $300-$700 annually depending on the type.

If you have a Medigap policy, it may cover your 20% coinsurance and Part B deductible, significantly reducing your costs for covered eye services.

Medicare Advantage Plan Costs

Medicare Advantage plans structure vision costs differently. Common cost-sharing includes:

Vision exam copayment: Usually $0-$50 for routine exams. Some plans cover one annual exam at no cost.

Eyewear allowance: Most plans provide $100-$300 toward glasses or contacts every year or every two years. Premium plans may offer higher allowances.

Additional pairs: Discounts of 20-40% on extra glasses purchased beyond your allowance.

Out-of-pocket maximum: Your plan's yearly spending cap protects you from catastrophic costs. In 2026, Medicare Advantage out-of-pocket maximums can't exceed $8,850 for in-network services, though many plans set lower limits.

Cataract Surgery Coverage

Medicare provides special coverage for eyewear after cataract surgery. If you have cataract surgery that includes insertion of an intraocular lens, Part B covers one pair of eyeglasses with standard frames or one set of contact lenses. You'll still pay 20% coinsurance for the glasses or contacts themselves.

This post-cataract eyewear coverage is a one-time benefit per eye surgery. If you have cataracts in both eyes, you're covered for eyewear after each surgery.

Types of Eye Conditions Medicare Covers

Understanding which eye conditions qualify for Medicare coverage helps you know when to schedule appointments and what to expect in terms of costs.

Diabetic Eye Disease

Diabetes affects nearly 34 million Americans, and about one-third of diabetics develop some form of diabetic retinopathy. Medicare recognizes this serious complication by covering comprehensive annual screenings for all Medicare beneficiaries with diabetes.

During a diabetic retinopathy screening, your eye doctor dilates your pupils and examines your retinas for signs of damage. They're looking for swelling, bleeding, or abnormal blood vessel growth that indicates diabetic retinopathy. Early detection allows for treatment that can prevent blindness.

Medicare covers seven dilated eye examinations over the course of your care if you're diagnosed with diabetic retinopathy. This means you can see your eye doctor more frequently than once a year for monitoring and treatment without worrying about coverage denials.

Glaucoma

Glaucoma affects over 3 million Americans and often has no symptoms until significant vision loss occurs. Medicare covers annual glaucoma screenings for high-risk individuals because early detection can prevent blindness.

The screening includes several tests:

Tonometry measures the pressure inside your eye. Elevated eye pressure is the primary risk factor for glaucoma.

Ophthalmoscopy allows your doctor to examine your optic nerve for damage. They look for cupping (hollowing) of the nerve that indicates glaucoma.

Visual field testing checks your peripheral vision. Glaucoma typically affects side vision first, so this test can detect early disease.

If you're diagnosed with glaucoma, Medicare covers ongoing treatment including prescription eye drops, laser procedures, and even surgery when medically necessary.

Age-Related Macular Degeneration (AMD)

AMD is the leading cause of vision loss in Americans over 50. It affects your central vision, making it difficult to read, drive, or recognize faces. Medicare covers diagnostic exams and monitoring when you show symptoms of AMD.

There are two types of AMD:

Dry AMD progresses slowly and currently has no cure, though nutritional supplements may slow progression. Medicare covers your exams to monitor the condition and covers supplements if your doctor prescribes them and you have Part D.

Wet AMD is more severe but treatable. Medicare Part B covers anti-VEGF injections directly into the eye to stop abnormal blood vessel growth. These injections can preserve or even improve vision. Treatment typically requires monthly or bi-monthly injections, all covered by Medicare.

Cataracts

Cataracts are so common that by age 80, more than half of Americans either have cataracts or have had cataract surgery. Medicare covers cataract surgery, including the surgeon's fees, facility costs, and one standard intraocular lens.

Medicare covers cataract surgery when your vision impairment interferes with daily activities like reading, driving, or watching television. Your ophthalmologist will document how cataracts affect your quality of life to justify medical necessity.

Premium intraocular lenses that correct astigmatism or provide multifocal vision aren't fully covered. Medicare covers the cost of a standard lens, and you pay the difference (typically $1,000-$3,000 per eye) if you choose an upgraded lens.

Pre-Exam Requirements and Documentation

Before Medicare approves coverage for eye exams, certain requirements must be met. Understanding these upfront prevents unexpected bills and coverage denials.

Medical Necessity Documentation

For Medicare to cover an eye exam, your doctor must document medical necessity. This means showing a specific medical reason for the exam beyond simply needing new glasses.

Medical necessity might be established by:

Existing diagnosis: If you have diabetes, glaucoma, or AMD, this alone justifies covered screenings.

New symptoms: Vision changes like blurriness, floaters, flashes of light, pain, or double vision warrant medical eye exams.

Risk factors: Family history of glaucoma, previous eye injuries, or certain medications that affect vision can justify coverage.

Follow-up care: Monitoring a previously diagnosed condition qualifies as medically necessary.

Your eye doctor will document these factors in your medical record. If Medicare questions the necessity, this documentation supports coverage approval.

Referrals and Prior Authorization

Original Medicare doesn't require referrals for eye care—you can schedule appointments directly with any Medicare-approved ophthalmologist or optometrist. However, Medicare Advantage plans often require referrals from your primary care doctor before covering specialist visits.

Prior authorization requirements vary by Medicare Advantage plan and procedure. Routine eye exams rarely need prior authorization, but procedures like injections for wet AMD or specialized diagnostic testing might require it. Check with your plan before scheduling to avoid surprise denials.

Choosing Medicare-Approved Providers

To ensure coverage, verify your eye doctor accepts Medicare assignment. Providers who accept assignment agree to Medicare's approved payment amounts and can't charge you more than the standard deductible and coinsurance.

Use the Physician Compare tool on Medicare.gov to verify providers. When calling to schedule, confirm:

• Do you accept Medicare assignment?

• Are you accepting new Medicare patients?

• Do you participate in my Medicare Advantage plan's network (if applicable)?

With Medicare Advantage, staying in-network is critical. Out-of-network eye care might not be covered at all, or you'll face significantly higher costs.

Post-Exam Coverage and Follow-Up Care

Medicare coverage continues beyond your initial eye exam, covering necessary follow-up care and treatments for diagnosed conditions.

Treatment Coverage

If your eye exam reveals a condition requiring treatment, Medicare Part B covers medically necessary procedures and therapies:

Laser treatments for diabetic retinopathy or glaucoma are covered at 80% after your deductible. These outpatient procedures can prevent vision loss and typically require multiple sessions.

Injections for wet AMD are covered under Part B, not Part D, because they're administered by your doctor during office visits. You'll pay 20% coinsurance for each injection, which typically occurs monthly or every other month.

Minor surgical procedures like removing eyelid cysts, repairing blocked tear ducts, or treating pterygium (growths on the eye) are covered as outpatient surgery under Part B.

Follow-Up Appointments

Medicare covers follow-up visits when medically necessary to monitor your condition or adjust treatment. The frequency of covered follow-ups depends on your diagnosis:

Diabetic retinopathy: Up to seven dilated exams may be covered if your condition requires close monitoring.

Glaucoma: Medicare covers appointments every 3-6 months if you're being treated for glaucoma, with more frequent visits if your eye pressure is unstable.

Post-surgical care: All post-operative visits are included in the surgical fee for 90 days after procedures like cataract surgery, meaning no additional cost to you.

Diagnostic Testing Coverage

When your eye doctor orders diagnostic tests to monitor your condition, Medicare Part B covers these services:

Optical coherence tomography (OCT) creates detailed images of your retina layers. Medicare covers OCT for diagnosing and monitoring AMD, diabetic retinopathy, and glaucoma.

Visual field testing measures your peripheral vision. Medicare covers this test when monitoring glaucoma or neurological conditions affecting vision.

Fluorescein angiography uses dye to photograph blood flow in your retina. Medicare covers this test when evaluating diabetic retinopathy or wet AMD.

You'll pay 20% coinsurance for these diagnostic tests after meeting your Part B deductible.

Medigap and Vision Insurance Options

Original Medicare's vision coverage gaps leave many beneficiaries seeking additional insurance to reduce out-of-pocket costs.

Medigap Coverage

Medigap policies don't add vision benefits but can reduce your costs for covered services. These supplemental plans help pay the 20% coinsurance and Part B deductible for medically necessary eye exams and treatments.

Plan G is the most comprehensive option for new Medicare beneficiaries. It covers the 20% coinsurance for all covered eye services, meaning you'd only pay the $240 Part B deductible in 2026.

Plan N offers lower premiums but requires a $20 copayment for office visits, including eye appointments. You'd pay the Part B deductible plus $20 per visit.

Medigap doesn't cover routine vision care, so you'd still pay out-of-pocket for prescription eyewear and non-covered exams.

Stand-Alone Vision Insurance

Many insurance companies offer vision insurance plans specifically for routine eye care. These plans typically cost $10-$30 per month and cover:

• Annual comprehensive eye exams

• Allowance toward frames and lenses (usually $130-$200)

• Discounts on additional eyewear purchases

• Savings on contact lenses and solutions

Popular vision insurance companies include VSP, EyeMed, and Davis Vision. These plans work alongside Medicare—Medicare covers your medical eye care, and vision insurance covers your routine needs.

Before purchasing stand-alone vision insurance, calculate whether the annual premiums plus copayments cost less than paying directly for an exam and glasses. For many people, paying out-of-pocket once every two years is more economical than maintaining year-round vision insurance.

Medicare Advantage Vision Benefits

If you don't have Medicare Advantage but want comprehensive vision coverage, switching during the Annual Enrollment Period (October 15 - December 7) might be worthwhile. Compare plans carefully:

Network size: Ensure your preferred eye doctor participates or be willing to switch providers.

Benefit limits: Some plans offer generous eyewear allowances ($300+) while others provide minimal coverage ($100).

Frequency: Most plans cover eyewear annually or every two years. If you need frequent prescription changes, annual coverage is more valuable.

Premium costs: Vision benefits add value, but only if the plan's overall costs make sense for your health needs.

Common Medicare Coverage Denials and Appeals

While Medicare eye care denials are less common than for some services, they do occur. Understanding common denial reasons helps you prevent them or successfully appeal.

Frequent Denial Reasons

Routine vs. medical distinction. The most common denial occurs when Medicare determines an exam was routine rather than medically necessary. If you scheduled an exam just to update your prescription without symptoms or a qualifying diagnosis, Medicare will deny coverage. Your claim should clearly indicate medical necessity through diagnosis codes and documentation.

Frequency limitations. Medicare covers one glaucoma screening annually for high-risk individuals. If you're not high-risk or already had your annual screening, additional tests may be denied unless new symptoms justify them.

Non-covered services billed to Medicare. Sometimes providers incorrectly bill routine services to Medicare. When Medicare denies these claims, you're responsible for payment. Verify before your exam which services are covered to avoid surprise bills.

Out-of-network providers. If you have Medicare Advantage and see an out-of-network eye doctor without prior authorization, your plan may deny coverage entirely.

The Appeals Process

If Medicare denies coverage for your eye exam or treatment, you have strong appeal rights. According to CMS data, beneficiaries who appeal coverage denials win their cases approximately 50% of the time at the initial level.

The appeals process has five levels, though most cases are resolved at the first or second level:

Level 1: Redetermination (within 120 days of denial). Submit a written request to your Medicare Administrative Contractor (MAC) explaining why the service was medically necessary. Include supporting documentation like medical records showing your symptoms, diagnosis codes, and a letter from your doctor justifying the need for the exam or treatment.

Level 2: Reconsideration (within 180 days of Level 1 decision). If your first appeal is denied, a Qualified Independent Contractor reviews your case. This level has a higher success rate because reviewers are independent of the original decision.

Your appeal should include:

• Complete medical records documenting your eye condition

• A detailed letter from your eye doctor explaining medical necessity

• Any relevant test results showing disease progression or risk factors

• Documentation of symptoms affecting your daily activities

Medicare Advantage appeals follow a similar structure but have shorter timeframes—typically 60 days for standard appeals or 72 hours for expedited appeals if your health is at risk.

Preparing Financially for Eye Care Costs

Planning ahead helps you manage eye care expenses and avoid financial surprises.

Getting Cost Estimates

Before scheduling any eye procedure beyond a basic exam, request cost estimates in writing. Contact both your eye doctor's office and the facility where the procedure will occur (if different) to ask about:

• The provider's fees

• Facility or equipment charges

• Diagnostic testing costs

• Expected Medicare payment amounts

• Your estimated out-of-pocket responsibility

These estimates aren't guaranteed but give you a realistic picture of what you'll owe. Medicare's Physician Fee Schedule (available on Medicare.gov) shows approved amounts for common eye procedures, helping you calculate your 20% coinsurance.

Affordable Eyewear Options

Since Medicare doesn't cover routine eyeglasses, finding affordable eyewear matters. Consider these cost-saving strategies:

Retail optical chains like Walmart, Costco, and Target offer complete glasses packages starting around $70-$100. Their in-house brands provide significant savings compared to designer frames.

Online retailers like Zenni Optical, EyeBuyDirect, and Warby Parker sell prescription glasses for as low as $15-$95, including lenses. You'll need your pupillary distance (PD) measurement, which your eye doctor can provide or you can measure yourself.

Lions Clubs and other charitable organizations offer free or low-cost eyeglasses to seniors who meet financial eligibility requirements. Contact your local Lions Club chapter or search for vision assistance programs in your area.

Discount programs like EyeMed's Access Plan or VSP's Individual Vision Plan provide members with reduced prices at participating providers without monthly premiums—you pay per use.

Financial Assistance Resources

If eye care costs overwhelm your budget, several resources can help:

Medicare Savings Programs help pay Medicare premiums, deductibles, and coinsurance if your income is limited. Four programs exist based on income level, with the most generous covering all Part A and Part B costs.

Medicaid may provide additional vision benefits if you're dually eligible. Many states offer routine eye exams and eyeglasses through Medicaid.

Pharmaceutical assistance programs help cover prescription eye drops for glaucoma and other conditions. Most drug manufacturers offer patient assistance programs for those who qualify based on income.

Payment plans are available at most eye care providers. Don't hesitate to ask about spreading costs over several months interest-free.

How an Aviator Health Advocate Can Help

Navigating Medicare vision benefits can be confusing, especially when dealing with medical necessity determinations, coverage denials, or finding affordable care options. An Aviator Health advocate removes these obstacles so you can focus on protecting your vision.

Understanding Your Benefits

Your advocate analyzes your specific Medicare coverage—whether Original Medicare, Medicare Advantage, or Medicare with supplemental insurance—and explains exactly what vision services you're entitled to. They'll help you understand the difference between covered medical eye care and non-covered routine vision services, preventing surprise bills.

If you're considering switching plans during Open Enrollment to get better vision benefits, your advocate compares plans based on your specific eye care needs. They'll evaluate network providers, eyewear allowances, and out-of-pocket costs to find the best value.

Coordinating Care

Eye care often involves multiple providers—your primary care doctor, ophthalmologist, optometrist, and potentially specialists for conditions like diabetic retinopathy. Your advocate ensures everyone has your current medical information and that care transitions smoothly between providers.

For diabetics, your advocate helps coordinate between your endocrinologist and eye doctor to ensure you receive recommended annual screenings and any necessary follow-up care. This coordination prevents gaps in care that could lead to vision loss.

Appealing Denials

If Medicare denies coverage for an eye exam, diagnostic test, or treatment, your advocate handles the entire appeals process. They know exactly what documentation Medicare requires to approve coverage and work with your eye doctor to gather compelling evidence.

Your advocate submits professionally written appeal letters that clearly articulate medical necessity, include all required supporting documentation, and reference relevant Medicare coverage policies. This expertise significantly increases your chances of overturning the denial.

Finding Affordable Care

Even with Medicare coverage, out-of-pocket costs for eye care can strain your budget. Your advocate helps you find:

Low-cost eyewear sources that accept your Medicare Advantage vision benefit or offer quality glasses at affordable prices without insurance.

Financial assistance programs for prescription eye medications, helping you access patient assistance programs or find generic alternatives.

Community resources like Lions Clubs, charitable vision programs, and discount programs that provide free or reduced-cost eye care to eligible seniors.

Managing Medical Bills

Eye care bills can be complex, especially after procedures involving multiple providers and services. Your advocate reviews every bill for errors, ensures Medicare was billed correctly, and identifies any overcharges.

Common billing errors include:

• Routine services incorrectly billed as medical services

• Duplicate charges for diagnostic tests

• Balance billing from providers who don't accept assignment

• Incorrect coding that triggers denials

Your advocate catches these errors and works with providers to correct them before you pay. If you're facing large bills, they'll negotiate payment plans and help identify financial assistance you qualify for.

Many Medicare beneficiaries find that having an advocate saves them hundreds or thousands of dollars while reducing the stress of managing vision care appointments, bills, and insurance requirements. Aviator Health advocacy services are often covered by Medicare Advantage plans or available at reasonable self-pay rates.

Frequently Asked Questions About Medicare Coverage of Eye Exams

Does Medicare cover routine eye exams for glasses?

No, Original Medicare doesn't cover routine eye exams for prescribing glasses or contact lenses. However, approximately 90% of Medicare Advantage plans include routine vision benefits that cover annual eye exams and allowances toward eyewear. If you have Original Medicare and want routine vision coverage, consider purchasing stand-alone vision insurance or switching to a Medicare Advantage plan during Annual Enrollment.

How often does Medicare pay for diabetic eye exams?

Medicare Part B covers one comprehensive dilated eye exam per year for all beneficiaries with diabetes. If you're diagnosed with diabetic retinopathy during your screening, Medicare covers up to seven additional dilated exams for ongoing monitoring and treatment. These exams don't count against your annual screening benefit—you can have frequent monitoring visits plus your yearly screening.

Does Medicare cover eyeglasses or contact lenses?

Medicare covers one pair of eyeglasses or contact lenses only after cataract surgery that includes insertion of an intraocular lens. This is a one-time benefit per surgery. Medicare doesn't cover routine eyewear, but many Medicare Advantage plans provide annual or biennial eyewear allowances ranging from $100 to $300.

What if I need eye surgery for something other than cataracts?

Medicare Part B covers medically necessary eye surgeries including procedures for glaucoma, detached retinas, eyelid problems affecting vision, and removal of eye tumors. You'll pay 20% coinsurance after meeting your Part B deductible. More complex surgeries requiring hospital admission may be covered under Part A instead. Your surgeon's office will verify coverage before scheduling.

Can I get a second opinion on recommended eye surgery?

Yes, Medicare covers second opinions when your doctor recommends surgery. You don't need a referral if you have Original Medicare—simply schedule with another Medicare-approved ophthalmologist. Medicare Advantage plans may require referrals for second opinions, so check your plan requirements. Getting a second opinion is especially valuable for procedures like cataract surgery or treatments for AMD.

Does Medicare cover laser vision correction?

No, Medicare doesn't cover LASIK, PRK, or other laser vision correction procedures for refractive errors like nearsightedness, farsightedness, or astigmatism. These are considered cosmetic procedures. However, Medicare does cover therapeutic laser treatments for medical conditions like glaucoma, diabetic retinopathy, and retinal tears. The distinction is medical necessity—treatment of disease is covered while vision enhancement isn't.

Summary

Medicare provides essential coverage for medical eye care including diabetic retinopathy screenings, glaucoma tests for high-risk individuals, and treatment of eye diseases. While Original Medicare doesn't cover routine vision care, Medicare Advantage plans often fill this gap with comprehensive vision benefits including annual exams and eyewear allowances.

Understanding the distinction between medical and routine vision care helps you maximize your benefits and minimize out-of-pocket costs. In 2026, expect to pay 20% coinsurance after your $240 Part B deductible for covered medical eye services. For non-covered routine care, budget $50-$250 for eye exams and $200-$600 for prescription eyewear, or explore Medicare Advantage plans with vision benefits during Annual Enrollment.

Your vision is precious—don't let confusion about coverage prevent you from getting necessary eye care. Take advantage of covered preventive screenings, especially if you have diabetes or other risk factors for eye disease. Early detection of conditions like glaucoma and macular degeneration can preserve your sight for years to come.

If navigating Medicare vision benefits feels overwhelming, you don't have to figure it out alone. Whether through family support, your eye care providers, or a patient advocate, having help makes the complex Medicare system manageable. Your eyes deserve the best care Medicare offers.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.