Medicare Vision Plans

Original Medicare usually does not cover vision-related services unless it is for certain circumstances, such as surgery. However, some Medicare Advantage Plans will cover other vision-related services or items. 

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What does Original Medicare cover?

Original Medicare will more than likely not cover routine vision exams but will provide coverage under certain circumstances. For example, Original Medicare will pay if:

  • Your vision condition is considered a medical emergency or traumatic injury, and you are admitted into the hospital.
  • You need cataract surgery, or had cataract surgery and need vision correction, such as glasses or contact lenses.
  • You are at high risk or have a family history of glaucoma. In this case, Medicare Part B will cover a yearly glaucoma screening.
  • You need a vision exam to check for diabetic retinopathy.
  • You have eye prosthesis due to a birth defect, trauma, or surgical removal. 
  • You need ocular photodynamic therapy.

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Eye exam costs

Depending on where you receive your services from, the costs of each service could vary because many eye doctors will charge whatever they feel is necessary for their services. The prices will also depend on the location of the business. For example, if it is located in a large metropolitan area, you could end up paying more.

For many, an initial patient exam could cost up to $200, and an established patient exam could cost up to $128. The average cost of a refractive eye test can range up to $46. While these are not the most expensive costs from services you can receive regarding your vision, they can give you an idea of what to expect if these services aren’t covered by Medicare.