Quick Answer
Yes, Medicare Part B covers annual glaucoma screenings for beneficiaries at high risk, including people with diabetes, a family history of glaucoma, African Americans age 50 and older, and Hispanic Americans age 65 and older. Medically necessary glaucoma treatment - including surgery and prescription eye drops - is also covered. Routine eye exams are generally not covered unless they include a glaucoma screening.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Annual Glaucoma Screening (high-risk) | Covered | Part B covers once per year for high-risk beneficiaries |
| Glaucoma Treatment (surgery, laser) | Covered | Part B covers medically necessary surgical and laser procedures |
| Prescription Eye Drops | Covered | Part D covers prescription glaucoma medications on formulary |
| Routine Eye Exams | Not Covered | Standard vision exams not covered unless medically necessary |
| Eyeglasses / Contact Lenses | Not Covered | Medicare does not cover routine vision correction |
| Medicare Advantage | Varies | Many MA plans include routine vision benefits beyond Original Medicare |
Understanding Your Coverage Options
Medicare Part B - Glaucoma Screening
Covered once per year for high-risk beneficiariesMedicare Part B covers one glaucoma screening per year for beneficiaries who are at high risk for glaucoma. The screening must be performed or supervised by an eye doctor who is legally allowed to perform the exam in your state.
High-risk groups covered by Medicare include: people with diabetes, individuals with a family history of glaucoma, African Americans age 50 and older, and Hispanic Americans age 65 and older.
If you are not in a high-risk group, Medicare does not cover routine glaucoma screenings. However, if your doctor identifies a medical reason to test for glaucoma during a covered visit, the testing may be covered as medically necessary.
What It Covers
- Annual glaucoma screening for high-risk beneficiaries
- Comprehensive dilated eye exam when medically necessary
- Diagnostic testing (visual field testing, optic nerve imaging)
- Medically necessary follow-up visits
- Glaucoma surgery (trabeculectomy, tube shunt procedures)
- Laser procedures (SLT, ALT, iridotomy)
What It Doesn't Cover
- Routine eye exams for eyeglass or contact lens prescriptions
- Eyeglasses or contact lenses
- Glaucoma screenings for non-high-risk beneficiaries
You pay 20% coinsurance after the $283 annual Part B deductible for covered services. A Medigap plan can cover this 20%.
Medicare Part D - Prescription Eye Drops
Covered - formulary varies by planMedicare Part D covers prescription glaucoma medications including prostaglandin analogs (latanoprost, bimatoprost), beta-blockers (timolol), and carbonic anhydrase inhibitors (dorzolamide). Coverage and cost-sharing vary by plan formulary.
In 2026, the maximum out-of-pocket cap for Part D is $2,000, providing protection for beneficiaries on multiple medications.
What It Covers
- Prostaglandin analogs (latanoprost/Xalatan, bimatoprost/Lumigan, travoprost/Travatan)
- Beta-blockers (timolol, betaxolol)
- Carbonic anhydrase inhibitors (dorzolamide/Trusopt, brinzolamide/Azopt)
- Alpha-2 agonists (brimonidine/Alphagan)
- Combination eye drops
What It Doesn't Cover
- Over-the-counter eye drops
- Medications not on your plan's formulary
Compare Part D plans each year during Open Enrollment (Oct 15 – Dec 7) to ensure your glaucoma medications are covered at the lowest tier.
Medicare Advantage - Additional Vision Benefits
May include routine vision benefitsMedicare Advantage plans must cover all Original Medicare benefits including glaucoma screenings and treatment. Many plans also offer supplemental vision benefits such as routine eye exams, eyeglass frames and lenses, and contact lens allowances - benefits not available under Original Medicare.
If you have glaucoma or are at high risk, compare Medicare Advantage plans in your area to find one with strong ophthalmology network coverage and vision benefits.
What It Covers
- All glaucoma services covered by Original Medicare
- Potentially: routine eye exams, eyeglass allowances, contact lens benefits
What It Doesn't Cover
- Benefits vary significantly by plan - review your plan's Evidence of Coverage
✦ Frequently Asked Questions
Jagger Esch
AuthorJagger Esch is the Medicare Educator at MedicareFAQ and the founder of Elite Insurance Partners.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare.