Does Medicare cover it?
Does Medicare cover eye exams?
It depends on why you need the exam. Pick the exam in the estimator: a medical eye exam is priced at the 2026 rate for your area, a routine exam for glasses at the price you type.
What this service costs you
You pay
$124
| Medicare-approved amount | $124 |
| Part B deductible used | $124 |
| Deductible left after this | $159 |
Part B: you pay the yearly deductible ($283 in 2026), then 20% of the approved amount.
Same service at national rates: $127
How this is calculatedOriginal Medicare does not cover routine eye exams, the refractions done to prescribe eyeglasses or contact lenses: you pay all of that cost. It does cover eye care with a medical reason under Part B. People with diabetes get an exam for diabetic retinopathy once a year, from an eye doctor legally allowed to do the test in their state. People at high risk get glaucoma tests. Exams to diagnose or treat an eye disease are covered as doctor services. All of these follow the Part B deductible, $283 in 2026, then 20% of the approved amount. A medical eye exam for an established patient is approved at $127 nationally in an eye doctor's office, so $25 for you; the same exam in a hospital outpatient department costs you $40 because the hospital adds its copayment. A glaucoma test for a person at high risk leaves you $13. Some Medicare Advantage plans offer vision benefits that Original Medicare does not, including routine exams; contact the plan.
Which eye exam is covered?
You pay
$25
| Covered by Part B | Yes |
| Approved amount | $127 |
Deductible met, national rates.
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
Covered or not: the reason decides
| Exam | Covered? | Approved | You pay |
|---|---|---|---|
| Routine exam for glasses or contacts | No | – | All of it |
| Diabetic retinopathy exam, once a year | Yes, with diabetes | $127 | $25 |
| Medical eye exam, in an office | Yes | $127 | $25 |
| Medical eye exam, hospital outpatient | Yes | $198 | $40 |
| Glaucoma screening for people at high risk | Yes, if at high risk | $64 | $13 |
An office visit with an eye doctor can include both kinds of work: checking the health of the eye, which Medicare may pay when there is a medical reason, and measuring your prescription for glasses, which it never pays. The bill can then show a covered line and a line that is entirely yours.
What the deductible and your area change
If the eye exam is your first Part B bill of the year, the deductible takes the whole approved amount, and you pay $127 instead of $25. The physician fee schedule also follows your price area: the same office exam is approved at $144 in Manhattan and $117 in Alabama. Choose your state in the estimator above to see your local amount.
Where the exam is done
In an eye doctor's own office, you pay 20% of one approved amount. In a hospital outpatient department, the eye doctor bills a lower professional fee and the hospital adds its facility charge, with its own copayment: $40 for you against $25 in an office, at national rates. For a yearly exam with no urgency, the office is usually the cheaper choice for you.
Medigap on a covered eye exam
For a medical eye exam, Medigap Plan G pays the 20% once the deductible is met and leaves you $0; Plan K pays half and leaves $13. In January, before the deductible is met, Plan G leaves you the deductible part, $127 here.
After cataract surgery
Medicare does not pay for glasses in general, with one exception: one pair of glasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. The glasses page prices that pair, and the cataract surgery page the operation itself.
Vision benefits outside Original Medicare
Some Medicare Advantage plans offer extra benefits Original Medicare does not cover, such as vision services. The amounts and the network are in the plan's Summary of Benefits. In the estimator, choose Medicare Advantage and enter any allowance the plan gives next to the price of a routine exam to see what remains for you. Coverage rules come from the medicare.gov routine eye exams page and the medicare.gov diabetic eye exams page.