Medicare Eye Exams: What You Should Know Before Your Visit

Dr. Ryan Corte
6 days ago
4 min read

Are you looking for an eye doctor that accepts Medicare in Charlotte or Asheville, NC?

If so, look no further, Reflect Vision Care proudly accepts Medicare! We also accept a variety of vision and medical insurance plans to make your eye care both accessible and affordable.

Below, we’ve answered the most common questions patients ask about Medicare eye coverage, what’s included, and how to make the most of your benefits when visiting our office.

Important: Please bring your active Medicare card (and supplemental insurance card, if applicable) to your appointment.

Does Medicare Cover Routine Eye Exams and Glasses?

Unfortunately, Medicare does not cover routine vision exams or glasses for adults. That means standard annual checkups or new eyeglass prescriptions are not included under traditional Medicare (Part A and Part B).

However, there’s great news, Medicare does cover medical eye exams when related to an eye health condition or systemic disease.

These medical visits may include evaluation or management of:

Glaucoma
Cataracts
Macular degeneration
Dry eye disease
Allergies or eye infections (e.g., pink eye)
Eye pain or headaches
Flashes, floaters, or vision loss
Ocular side effects of systemic conditions like diabetes or hypertension

Note: Most Medicare patients have a small deductible that must be met before coverage begins. This is typically satisfied after one or two medical office visits.

At Reflect Vision Care, many of our patients with Medicare are seen for medical eye exams each year. If you would also like an updated glasses prescription during your visit, we can provide that for a small refraction fee, a service not covered by Medicare but offered affordably for your convenience.

Does Medicare Cover Contact Lenses?

No. Medicare does not cover contact lens materials or fitting fees. That means if you’re interested in wearing contact lenses, this would be an out-of-pocket expense.

However, Reflect Vision Care offers economical contact lens evaluations and carries only safe, high-quality lens brands that provide exceptional comfort and vision, without breaking the bank.

Does Medicare Cover Eye Exams for Cataracts?

Yes. Medicare does cover medical eye exams to evaluate and monitor cataracts.

During your visit, your optometrist will assess the severity of your cataracts, discuss your symptoms, and help determine whether you’re ready for surgery or if your vision can be managed with an updated prescription.

Does Medicare Cover Cataract Surgery?

Yes! Medicare covers most of the cost of cataract surgery.

Here’s what you need to know:

Medicare Part B covers 80% of the cost of cataract surgery when performed by an in-network surgeon.
If you have supplemental insurance, it typically pays the remaining 20%.
The coverage includes the removal of the cataract and implantation of a standard intraocular lens (IOL).

If you choose to upgrade to a premium or multifocal lens, the additional cost is usually not covered and would be an elective, out-of-pocket upgrade.

At Reflect Vision Care, we manage your pre- and post-operative cataract care locally, seeing you one week and one month after surgery to ensure your healing is on track and to determine if you need glasses afterward.

Does Medicare Pay for Glasses After Cataract Surgery?

Yes, partially. Medicare covers one pair of glasses or contact lenses after cataract surgery with a standard IOL. This benefit applies to your first pair only, following the surgery.

If you choose frames or lenses above the standard allowance, you would be responsible for the difference in cost.

Does Medicare Cover Glaucoma Testing?

Yes. Medicare covers glaucoma testing and follow-up care when medically necessary.

At Reflect Vision Care, we use advanced diagnostic technology, such as OCT imaging, visual field testing, and intraocular pressure analysis, to monitor and manage glaucoma.

Patients at higher risk (for example, those with diabetes, a family history of glaucoma, or African American heritage) are typically recommended to have annual glaucoma screenings.

Does Medicare Cover Diabetic Eye Exams?

Yes! Medicare covers 80% of a comprehensive diabetic eye exam to monitor for diabetic retinopathy and other retinal changes.

If you have supplemental insurance, it usually covers the remaining 20%, so most patients pay little or nothing out of pocket.

During your diabetic eye exam, our doctors will:

Examine your retina for any signs of bleeding or swelling
Check for cataracts, glaucoma, or macular edema
Send a detailed report to your primary care physician to ensure continuity of care

This annual exam is one of the most important preventive steps you can take to protect your vision and overall health.

Does Medicare Pay for Glasses for Diabetic Patients?

Unfortunately, no. Medicare does not cover glasses for patients with diabetes unless it is following cataract surgery. Routine eyewear expenses remain out-of-pocket.

Does Medicare Cover LASIK or PRK?

No. Medicare does not cover LASIK or PRK surgery, as these procedures are considered elective or cosmetic.

This is similar to other elective surgeries such as cosmetic rhinoplasty or liposuction. However, if you’re interested in laser vision correction, we can help you explore discounted options through partnered LASIK centers.

What About Medicare Advantage Plans (Part C)?

If you have a Medicare Advantage plan (also called Part C), your benefits may include routine vision coverage, depending on your provider.

Many Advantage plans, such as those through UnitedHealthcare, Aetna, Humana, or Blue Cross Blue Shield, offer:

One annual routine vision exam
Frame and lens allowances
Contact lens benefits
Additional discounts on lens enhancements or LASIK

At Reflect Vision Care, we can verify your specific plan details before your visit so you know exactly what’s covered.

Additional Medicare Tips

Always bring both your Medicare and supplemental insurance cards to your appointment.
Medical eye exams (for conditions like glaucoma, cataracts, or diabetes) are billed to Medicare Part B.
Routine vision services (like refractions for glasses) are typically not covered.
Supplemental plans often cover the remaining 20% after Medicare pays its portion.

Why Choose Reflect Vision Care for Your Medicare Eye Care

At Reflect Vision Care, our experienced doctors provide both routine and medical eye care for Medicare patients across Charlotte and Asheville.

We use the latest diagnostic technology for early detection of eye diseases and take the time to explain your results in detail. Whether you’re managing cataracts, monitoring diabetes, or simply keeping up with your vision health, you’ll receive personalized, compassionate care at every visit.

Schedule Your Medicare Eye Exam Today

Ready to schedule your next medical or comprehensive eye exam? Our friendly team will help you verify your Medicare benefits and ensure a smooth experience from start to finish.

Schedule your eye exam at one of our convenient Reflect Vision Care locations:

📞 Call us or schedule online to book your appointment today!