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Does Medicare Cover Eye Exams? How Often Medicare Pays (2026)

Updated October 1, 2026

Reviewed October 1, 2026. Original Medicare doesn’t pay for routine eye exams for glasses or contact lenses. Part B does cover eye exams and tests tied to a medical need: a diabetic eye exam once a year if you have diabetes, a glaucoma test once every 12 months if you’re at high risk, and exams to diagnose or treat eye conditions such as cataracts or macular degeneration. For those covered services you generally pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026).

Quick answer: How often Medicare pays depends on why you need the exam. Diabetic retinopathy exams and glaucoma tests are covered once a year for people who qualify. Medically necessary visits for eye symptoms or disease are covered as often as your doctor needs to see you. Routine vision checks for new glasses aren’t covered by Original Medicare, but many Medicare Advantage plans include a yearly routine eye exam.

How often does Medicare pay for eye exams?

Eye service	Who qualifies	How often Medicare covers it	What you pay (Original Medicare)
Diabetic eye exam (diabetic retinopathy)	People with diabetes	Once a year	20% after the Part B deductible
Glaucoma test	People at high risk for glaucoma	Once every 12 months	20% after the Part B deductible
Exams and tests for eye disease or injury	Anyone with symptoms or a diagnosed eye condition	When medically necessary	20% after the Part B deductible
Macular degeneration tests and treatment	People with age-related macular degeneration	When medically necessary	20% after the deductible, including certain injected drugs
Simple vision test	New Part B enrollees	Once, during the “Welcome to Medicare” visit in your first 12 months of Part B	$0 if the provider accepts assignment
Routine eye exam for glasses (refraction)	Not covered	Not covered	100% of the cost

In a hospital outpatient setting, a facility copayment may also apply. Sources are listed at the end of this article.

Routine eye exams aren’t covered by Original Medicare

Medicare.gov is direct about this: “Medicare doesn’t cover routine eye exams (sometimes called ‘eye refractions’) for eyeglasses or contact lenses.” (Medicare.gov) If you visit an optometrist only to update your glasses prescription, you’ll usually pay the full bill yourself unless you have other vision coverage.

The one exception for glasses: Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. You pay 20% of the approved amount after the deductible and must use a Medicare-enrolled supplier. Read more in Does Medicare pay for cataract surgery?

Diabetic eye exams: once a year

If you have diabetes, Part B covers an eye exam for diabetic retinopathy once a year. The exam must be done by an eye doctor who is legally allowed to perform it in your state. You pay 20% of the Medicare-approved amount after the Part B deductible (Medicare.gov).

Because diabetes also puts you in the high-risk group for glaucoma, you may qualify for both the diabetic eye exam and the yearly glaucoma test. Ask the office to bill each correctly so they’re processed as covered services rather than a routine exam.

Glaucoma tests: once every 12 months for high-risk groups

Medicare Part B covers glaucoma tests once every 12 months if you’re at high risk. According to Medicare.gov, you’re considered high risk if at least one of these applies:

You have diabetes
You have a family history of glaucoma
You’re African American and age 50 or older
You’re Hispanic and age 65 or older

The test must be done or supervised by an eye doctor who is legally allowed to do it in your state. You pay 20% of the approved amount after the deductible.

Eye exams for medical problems

When you have symptoms such as sudden vision changes, flashes or floaters, eye pain, an eye injury or infection, a visit to diagnose and treat the problem is a medical service covered by Part B, not a routine exam. The same is true for ongoing care of a diagnosed condition like cataracts, glaucoma or macular degeneration. Part B may cover diagnostic tests and treatment for age-related macular degeneration, including certain injectable drugs given in the office (Medicare.gov).

Optometrist or ophthalmologist?

Medicare covers medically necessary eye care from either type of eye doctor as long as the service is within what they’re licensed to do in your state and they accept Medicare. Surgery, such as cataract removal, is done by an ophthalmologist. For more on specialist visits, see Does medical insurance cover an ophthalmologist?

How the visit is coded matters

A single appointment can include both a covered medical exam and a non-covered refraction. Many offices charge a separate fee for the refraction (the “which is clearer, one or two?” test used to write a glasses prescription), and Medicare won’t pay that part. Ask at check-in what will be billed to Medicare and what you’ll pay out of pocket. If the office thinks Medicare may deny something, they may ask you to sign an Advance Beneficiary Notice before the service.

Eye exams with Medicare Advantage

Medicare Advantage (Part C) plans must cover the same medically necessary eye care as Original Medicare. Many also add “extra benefits that Original Medicare doesn’t cover – like vision,” as Medicare.gov puts it. Plan vision benefits commonly include:

A routine eye exam, often once a year
An allowance toward eyeglasses or contact lenses
In-network optometrists and retail optical stores

Benefits, copays and allowances differ from plan to plan, and HMO members usually must use network providers. If routine vision matters to you, compare it during Open Enrollment, October 15 to December 7, 2026, for coverage that starts January 1, 2027. Our Medicare plan comparison worksheet includes vision line items, and Medicare Advantage HMO vs. PPO explains network rules.

Other ways to pay for routine eye exams

Stand-alone dental, vision and hearing insurance purchased separately. See our vision, dental and hearing coverage page.
Retail optical chains that list exam prices up front. See whether America’s Best takes Medicare or Medicaid and LensCrafters and Medicare.
Medicaid, if you’re dual-eligible, may cover routine vision depending on your state.
Retiree coverage from a former employer may include a vision benefit.

Frequently asked questions

Does Medicare cover a yearly eye exam?

Not a routine one. Original Medicare covers a yearly diabetic eye exam if you have diabetes and a glaucoma test every 12 months if you’re at high risk. Routine exams for glasses aren’t covered, though many Medicare Advantage plans include one.

How often does Medicare pay for eye exams for diabetics?

Once a year for diabetic retinopathy. You pay 20% of the Medicare-approved amount after the Part B deductible.

Does Medicare pay for glasses?

Generally no. The exception is one pair of standard eyeglasses or one set of contact lenses after each cataract surgery with an intraocular lens implant.

Does Medicare cover eye exams for dry eye or an eye infection?

Yes, visits to diagnose and treat a medical eye problem are covered under Part B, with the usual 20% coinsurance after the deductible.

Is the vision test at my “Welcome to Medicare” visit an eye exam?

No. The “Welcome to Medicare” preventive visit includes a simple vision test, not a full eye exam. It’s available once within the first 12 months you have Part B.

This article is general information, not medical or individual insurance advice. Medicare365 is not affiliated with or endorsed by the U.S. government or the federal Medicare program.