Medicare.gov

Eye exams (for diabetes)

Medicare Part B (Medical Insurance) covers eye exams for diabetic retinopathy if you’re eligible.

  • Covered by Part B
  • Once each year 

  • After the Part B deductible , you pay 20% of the Medicare-approved amount (other costs may apply) 

Coverage details

If you’re eligible, you must get the exam from an eye doctor who’s legally allowed to do the test in your state. 

Who's eligible

Medicare covers eye exams for diabetic retinopathy if you have diabetes. 

Costs

After you meet the Part B deductible , you pay 20% of the  Medicare-approved amount for  your doctor's services. In a hospital outpatient setting, you also pay a copayment

How often

If you’re eligible, you can get an eye exam for diabetic retinopathy once each year.

Ask your doctor or healthcare provider how much your test, item, or service will cost.

Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.

Specific amounts you could owe depend on:

  • Other insurance you may have

  • How much your doctor charges

  • If your doctor accepts assignment

  • The type of facility

  • Where you get your test, item, or service