Routine eye exams and glasses
Medicare.gov says Original Medicare doesn't cover routine eye exams, sometimes called refractions, for eyeglasses or contact lenses. You pay the full cost, and you also pay for most glasses and contacts. A Medigap policy doesn't change that, because Medigap only helps with services Original Medicare covers.
Eye care Part B does cover
| Service | Who and how often |
|---|---|
| Glaucoma test | Once every 12 months if you're at high risk (diabetes, family history, African American 50+, Hispanic 65+) |
| Diabetic retinopathy exam | Once a year if you have diabetes |
| Cataract surgery | When medically necessary, including the implanted lens |
| Glasses or contacts | One pair (or one set) after each cataract surgery with an intraocular lens |
For these services you pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026). In a hospital outpatient setting you also pay a copayment. Ohio's balance-billing law, Ohio Revised Code Chapter 4769, also bars Ohio-licensed optometrists, opticians and physicians from charging Medicare patients more than Medicare's rate for a covered service. See can I keep my doctor.
Medicare Advantage
Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. If eyewear matters to you, ask which eye doctors and optical stores are in the plan's network. See Medicare Advantage in Ohio.
Ohio Medicaid vision care
Ohio Medicaid covers routine eye exams and glasses under OAC 5160-6-01. The limits before prior authorization is needed:
- Ages 21 to 59: one comprehensive vision exam and one complete frame and pair of lenses every 24 months.
- Age 60 and older: one exam and one pair every 12 months.
- Contact lenses and low-vision aids: covered with prior authorization when medically justified.
If you have Medicare and full Ohio Medicaid, Medicare pays first for medical eye care and your MyCare Ohio plan provides your Medicaid vision benefit. Questions: Ohio Medicaid Consumer Hotline, 1-800-324-8680.
Get help
A licensed insurance agent who works with Benefits Life can explain vision options with Medicare and compare plans from the companies they work with, at no cost to you. You can request a call from a licensed insurance agent, or see plans for your ZIP code.
Related questions
Does Medicare cover diabetes supplies?
Monitors, strips, shoes and insulin.
Does Medicare cover hearing aids in Ohio?
Exams yes, hearing aids no.
Does Medicare cover dental in Ohio?
When it pays, and Ohio Medicaid dental.
Sources
- Medicare.gov — Eye exams (routine)
- Medicare.gov — Glaucoma screenings
- Medicare.gov — Eye exams (for diabetes)
- Medicare.gov — Eyeglasses and contact lenses
- Ohio Administrative Code — Rule 5160-6-01, Eye care services
- Ohio Revised Code — Chapter 4769, Balance billing of Medicare beneficiaries
More questions in this guide
- Can I keep my doctor when I go on Medicare in Ohio?
- Does Medicare cover assisted living in Ohio?
- Does Medicare cover dental in Ohio?
- Does Medicare cover diabetes supplies in Ohio?
- Does Medicare cover hearing aids in Ohio?
- Does Medicare cover home health care in Ohio?
- Does Medicare cover mental health care in Ohio?
- Does Medicare cover nursing home care in Ohio?
- How do I get rides to the doctor with Medicare in Ohio?
Part of the guide: Medicare basics for Ohioans · All questions
Frequently asked questions
Does Medicare pay for glasses after cataract surgery?
Yes. Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. You pay 20% of the Medicare-approved amount after the Part B deductible, plus any extra cost for upgraded frames, and the supplier must participate in Medicare.
How often does Ohio Medicaid pay for an eye exam and glasses?
Under OAC 5160-6-01, adults 21 to 59 can get one comprehensive eye exam and one pair of glasses every 24 months, and adults 60 and older every 12 months. More often requires prior authorization.
Who counts as high risk for glaucoma?
Medicare covers a glaucoma test once every 12 months if you have diabetes, a family history of glaucoma, are African American and 50 or older, or are Hispanic and 65 or older.
Medicare in your Ohio county
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