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Does Medicare cover eye exams?

Are street signs becoming hard to read? Passing faces turning blurry? It might be time for an eye exam. Vision problems become more common as people age. Having your eyes checked regularly can help you get ahead of the issue. But does Medicare cover eye exams? Usually no, it does not. Some Medicare Advantage plans may cover eye exams, though. If you want to find out if a Medicare plan covers eye exams, you’ll need to know the details of your coverage. Plus the type of eye exam you need.

 

 

What types of eye exams are covered by Medicare?

 

Medicare is divided into four parts – A, B, C and D. If you have a Medicare Advantage plan (Part C), you may have access to coverage for vision-related care like eye exams. Parts A and B, referred to as Original Medicare, do not typically cover vision-related costs. This is not always true, however. Some eye treatments may be covered for illness or injury. And Medicare Part B covers routine eye exams for people with certain conditions. The following tests are usually covered:

 
  • Diabetic eye test

    Medicare Part B covers a diabetic eye test, also known as a diabetic retinopathy test. This test is an annual diabetic eye exam that checks to ensure vision isn’t being affected by diabetes.

  • Glaucoma testing

    Glaucoma is a condition that can cause lasting damage to the eyes. People who are at high risk of glaucoma may have diabetes or a family history of glaucoma. Or they may be of African American ethnicity (and over age 50) or Hispanic ethnicity (and over age 65). In any of these cases, Medicare Part B will cover a yearly glaucoma test, which is a form of eye exam.

  • Macular degeneration testing

    Age-related macular degeneration is a condition that damages a small part of the retina, a light-sensitive section at the back of the eye. Medicare Part B will cover some macular degeneration treatments, as well as a macular degeneration test.

 

Cost of eye exams and vision services

 

If you have vision coverage through Medicare Part B, eye exams cost 20 percent of the Medicare-approved amount after you pay the deductible. If you don’t have vision coverage, eye exam costs can range from $75 to $200.* Other vision-related services vary greatly in cost depending on the condition being treated or tested for.

 

Does Medicare Advantage cover eye exams?

 

So, does Medicare cover routine eye exams? As we’ve seen, the answer depends on conditions you may have. Medicare Advantage, however, may cover services like eye exams, dental care and hearing aids. Original Medicare may not. If you have a Medicare Advantage plan (Medicare Part C), you may have access to coverage for vision, hearing and dental. This means a plan could cover your routine eye exams, as well as eyeglasses and contact lenses.

 

If you ever start to have vision problems, you’ll want to know you have access to an eye exam and any eye care that comes after. Explore Aetna Medicare Advantage plans and set yourself up with the vision coverage you need.
 

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