Medicare Eye Exam Coverage in 2026: Part B vs Medicare Advantage
The single most important Medicare-and-vision fact: Original Medicare does not cover routine eye exams for glasses. Part B does cover medical eye exams (glaucoma, AMD, diabetic retinopathy, cataract). Medicare Advantage plans typically add routine vision benefits.
Original Medicare vs Medicare Advantage: What is Covered
| Service | Original Medicare (Part A + B) | Medicare Advantage (Part C) |
|---|---|---|
| Annual routine eye exam for glasses | NOT covered | Covered by many plans; copay set by the plan |
| Glaucoma screening (high-risk patients) | Covered: 20% after deductible | Covered (Original benefits included) |
| Diabetic retinopathy screening (diabetics) | Covered: 20% after deductible | Covered (Original benefits included) |
| Age-related macular degeneration (AMD) | Covered when medically necessary | Covered (Original benefits included) |
| Cataract surgery + standard IOL | Covered: 20% after deductible | Covered; cost sharing set by the plan |
| Eyeglasses (post-cataract only) | One pair, 20% after deductible | Included + additional allowance |
| Routine eyeglasses (non-cataract) | NOT covered | Allowance set by the plan, if offered |
| Routine contact lenses | NOT covered | Allowance set by the plan, if offered |
2026 Part B annual deductible is $283 (per CMS, up from $257 in 2025). Coinsurance is 20% of the Medicare-approved amount.
The Glaucoma Screening Benefit
Medicare Part B covers one glaucoma screening every 12 months for high-risk patients. Per CMS, high risk is defined as:
- People with diabetes
- People with a family history of glaucoma
- African Americans aged 50 or older
- Hispanic Americans aged 65 or older
You pay 20% of the Medicare-approved amount after meeting the Part B deductible. See the dedicated glaucoma test cost page for full detail.
The Cataract Surgery Benefit
Medicare Part B covers medically necessary cataract surgery, including:
- Pre-operative evaluation (A-scan biometry, IOL calculation)
- The surgical facility fee
- The surgeon's fee
- A standard monofocal intraocular lens (IOL)
- Post-operative follow-up
- One pair of standard eyeglasses OR one set of contact lenses after surgery
Premium IOLs (multifocal, toric for astigmatism, light-adjustable) are NOT covered. You pay the difference between the standard IOL and the premium lens, which the surgeon quotes before surgery.
FAQ
Does Medicare cover eye exams in 2026?
Original Medicare covers medically necessary exams (glaucoma, AMD, diabetic retinopathy, cataract) but NOT routine vision tests. Medicare Advantage often includes routine.
What is the Part B eye exam copay?
20% of Medicare-approved amount after the $283 (2026) deductible. Medigap may cover the coinsurance.
Does Medicare cover glasses?
Only one pair after cataract surgery (Part B). Many Medicare Advantage plans add a glasses allowance; the amount is in the plan's Evidence of Coverage.
What is the difference between Part B and Medicare Advantage?
Part B is medical-only; Medicare Advantage bundles A + B and typically adds routine vision benefits.
Does Medicare cover LASIK?
No. LASIK is considered elective and is not covered by Original Medicare or most Medicare Advantage plans.
Sources
- Medicare.gov - eye exams (routine)
- Medicare.gov - glaucoma tests
- Medicare.gov - cataract surgery
- Medicare.gov - eyeglasses / contact lenses
- CMS - 2026 Part B deductible and coinsurance
Coverage varies by specific plan and county. Verify benefits with Medicare or your Medicare Advantage carrier before booking.