Original Medicare (Parts A & B): Eyeglasses and Glaucoma Tests

Eyeglasses are covered for cataract surgery, and glaucoma tests for those at high risk. Glaucoma is a leading cause of blindness in people over 60.

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Cost
20% of the Medicare-approved amount; Part B deductible applies; additional copay in hospital outpatient setting
Prior Authorization Required
No, but must be performed by a licensed optometrist or ophthalmologist
Provider Referral or Order Required
No

How To Receive

Details on how to apply

  1. Schedule an appointment with a licensed optometrist or ophthalmologist who accepts Medicare. Find an optometrist or opthalmologist near me

  2. When scheduling, let the provider know it is for a glaucoma test or for eyeglasses following cataract surgery.

  3. Attend the appointment and complete the test or fitting.

  4. Follow through with any recommendations or referrals from the provider.

Note that Medicare does not cover routine eye exams or eyewear, and does not cover glaucoma testing as part of a routine eye exam.

For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.

Availability
Once for eyeglasses after cataract surgery; Every 12 months for those at high-risk

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Eyeglasses

If your loved one has cataract surgery with an intraocular lens implant, Medicare Part B covers one pair of eyeglasses with standard frames (or one set of contact lenses).

Note that Medicare will only pay for eyeglasses or contact lenses from a supplier enrolled in Medicare, no matter if you or your provider submits the claim.

Glaucoma tests

Medicare Part B covers glaucoma tests once every 12 months for those at high risk for developing glaucoma. Your loved one is considered at high risk if at least one or more of these conditions applies:

What is glaucoma?

Glaucoma is a disease that damages the optic nerve, affecting one's ability to see, as well as the general health of the eye tissue. Fluid builds up in the front part of the eye and causes an increase in pressure. As amazing as the eye is, it is rather fragile, and an increase in pressure can cause significant and irreversible damage.

Two types of glaucoma

Open-angle glaucoma. The most common type of glaucoma, it occurs gradually over time. The eye does not drain fluid as well as it should and, as a result, eye pressure builds and damages the optic nerve. This type of glaucoma is painless and vision changes do not occur in the early stages, which is why it's all the more important to get regular eye checks.

Angle-closure glaucoma (also called closed-angle or narrow-angle). This is the less common type of glaucoma and occurs when the iris (the colored part of the eye) is too close to the drainage angle of the eye and ends up blocking the drainage. When the drainage is completely blocked, eye pressure rises rapidly, and is called an acute attack. This is an eye emergency requiring the attention of an ophthalmologist right away - before irreversible blindness occurs. An acute attack is painful and vision changes occur immediately. Symptoms include:

Many people with angle-closure glaucoma develop it slowly. This is called chronic angle-closure glaucoma. There are no symptoms at first, so someone may not know until they have an acute attack. Again, why regular eye checks are so important.

Glaucoma can often be prevented with early treatment, which is why your loved one should be getting checked once a year if they are at high risk.

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