Original Medicare doesn’t cover your routine eye exams but will cover exams related to other conditions. For routine eye exams, you may find coverage through Medicare Advantage.
Original Medicare Coverage for Eye Exams
Original Medicare (Part A and Part B) covers emergency hospital care and general medical care, including preventative care. Logically, then, eye exams are covered, right? Not technically.
The U.S. and state governments have debated including dental, vision, and hearing coverage in Original Medicare for a while but still haven’t reached any conclusions. For now, you can only receive dental, vision, and hearing coverage for treatments and exams related to other conditions or in the case of an emergency.
Say, for instance, you fall and get a harmful substance in your eyes. The trip to the emergency room and your eye exam will be covered under Medicare Part A. Part B will also cover the diagnosis, treatment, and surgery for cataracts.
Or, perhaps you have a condition that requires eye exams and treatment. Part B will cover the diagnosis, treatment, and surgery for cataracts, and Part A will cover your emergency room fees if you have to stay in the hospital after surgery.
Part B covers eye exams and other eye tests under certain situations or if you have specific risk factors for disease. Eye exams related to diabetes, glaucoma, and diabetic retinopathy, for example, are covered.
What Medicare Advantage Covers
Medicare also has the option to get coverage for routine eye exams, but not through Original Medicare. Instead, you may consider a Medicare Advantage plan.
Medicare Advantage plans are offered by private insurance companies. They cover all of the benefits of Original Medicare and offer even more benefits on top of them. The exact benefits offered by each Medicare Advantage plan will vary, but that means you have the option to find the Advantage plan that best works for you.
Routine dental, vision, and hearing exams are common additional benefits of a Medicare Advantage plan. So, suppose you’re interested in regular eye exam coverage. In that case, it may be easy to find a Medicare Advantage plan that works for you. Just make sure to find the best price and compare your plan options.
The Right Support for Your Questions—Call Dale Frank Financial
Understand your Medicare coverage, and get help finding the eye exam benefits you need with Dale Frank Financial. For the best support for your Medicare journey, call Dale Frank Financial at (800) 585-5544.
*Disclosure: Dale Frank Financial offers insurance products but is not affiliated with Medicare or the U.S. government. Insurance product guarantees are backed by the financial strength and claims-paying ability of the issuing company.
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