Eye exams (for diabetes)
Medicare Coverage Information
Overview
Medicare provides coverage for annual eye exams for beneficiaries with diabetes to help detect and prevent diabetic eye complications. These specialized exams are crucial for early detection of diabetic retinopathy and other vision-related diabetes risks.
- Covers annual eye exams for people with diabetes
- Helps screen for diabetic retinopathy and other vision complications
- Exam must be performed by Medicare-approved eye care professionals
- Part B coverage applies after meeting annual deductible
- Medicare Part B beneficiaries with diagnosed diabetes
- Individuals with Type 1 or Type 2 diabetes
- Must be enrolled in Original Medicare or certain Medicare Advantage plans
- Beneficiaries pay 20% of the Medicare-approved cost after meeting Part B deductible
- Annual deductible for Part B is $240 in 2024
- No additional copayment if exam is performed in a hospital outpatient setting
- Must have a diagnosis of diabetes
- Limited to one comprehensive dilated eye exam per year
- Exam must be considered medically necessary
- Requires referral from primary care physician
- Confirm coverage with your specific Medicare plan
- Get a referral from your primary care physician
- Schedule an exam with a Medicare-approved eye care professional
- Call 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicarediabetes eye examdiabetic retinopathy screeningMedicare eye coveragediabetes healthcare
Related Coverage Topics
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