Does Medicare Cover Diabetic Eye Exams?
The short answer is yes – Original Medicare does cover diabetic eye exams. Diabetes can cause changes to the blood vessels in your retina. If these changes are not monitored and treated promptly, you could be at high risk of permanent damage or vision loss. Medicare and other health insurance plans cover regular eye exams for those beneficiaries with diabetes to encourage blindness prevention.
How Does Medicare Cover Diabetic Eye Exams?
Medicare Part B provides coverage for an annual eye exam for people with diabetes to detect diabetic retinopathy. The eye exam must be administered by an eye doctor authorized by law to operate in your state.
- You are responsible for your annual Part B deductible and 20% coinsurance of the Medicare-approved amount for any medical services your doctor provides.
- In a hospital outpatient facility, you must pay a copayment.
What Type of Eye Exam Is Covered?
One diabetic eye exam per year is covered. This test is known as a dilated eye exam, where your eye doctor will put drops in your eyes to dilate (enlarge) your pupils.
They will then look at the back of your eye to check for any signs of eye disease or damage. This exam aims to catch eye conditions early and start treatment immediately to prevent further damage.
Routine vision care and eye exams are essential to managing diabetes, maintaining health, and preventing long-term complications. Fortunately, Original Medicare will cover diabetic eye exams once a year.
Ask your doctor or healthcare provider any questions or concerns regarding your diabetic eye care.
Does Medicare pay for eyeglasses if you have diabetes?
No, Medicare coverage will not pay for eyeglasses or contact lenses for people with diabetes.
Are diabetic eye exams and routine eye exams the same thing?
No, a diabetic eye exam is more comprehensive than a regular eye exam. During the exam, your doctor will look for signs of damage or disease that can be caused by diabetes. They will also check for changes requiring further testing, screenings, or treatment.