Best Ophthalmologists That Will Accept Medicare (2022)

If you need to find ophthalmologists that accept Medicare, any routine eye exam for contact lenses or prescription glasses will not be covered. Other medical procedures, such as surgeries or visits because of an infection, may be covered. You can speak to your Medicare provider to learn more about what is and is not covered under your plan, and you may be able to find several ophthalmologists near you who accept Medicare.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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UPDATED: Jun 17, 2022

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The Highlights

  • Routine eye exam visits with an ophthalmologist are not covered by Medicare
  • A visit to the ophthalmologist because you have an eye injury or some other pain or issue would be covered by your Medicare insurance
  • You can look for quotes online to compare Medicare insurance that works with ophthalmologists near you

If you have Medicare, you may be curious whether your Medicare insurance covers a visit to the ophthalmologist.

Typically, Medicare does not cover routine vision care. But Original Medicare will cover visits to an ophthalmologist for many different reasons, including corrective surgeries and eye injuries.

Most Medicare Advantage insurance companies, like State Mutual and Manhattan Life Medicare, also cover these visits.

If you are looking to learn more about ophthalmologists that accept Medicare and Medicaid near you, you can use our free quote tool above to find affordable ophthalmologist Medicare insurance that works for you.

Does Medicare cover ophthalmologists?

Original Medicare plans will cover services for a person who:

  • Suffers from eye injuries
  • Has developed complications due to a disease
  • Has developed complications after a surgical procedure
  • Is admitted to the hospital or nursing facility and requires medically necessary care

In addition to the reasons listed above, Medicare Part B will continue to cover certain non-routine procedures that are considered medically necessary.

These procedures may include corrective surgeries following various treatments, such as cataract surgery. Medicare Part B may also cover:

  • High-risk patients who need glaucoma screenings
  • Surgery for cataracts
  • Surgery for vision correction
  • Eye prostheses
  • Photodynamic therapy

Original Medicare will likely require that patients pay for 20% of their procedures as the Medicare coinsurance fee.

If you have a Medicare Advantage plan, your coverages may be quite similar. But you will need to familiarize yourself with your policy to be sure what is and is not covered when it comes to visiting an ophthalmologist.

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What’s the difference between an ophthalmologist and an optometrist?

Basically, an ophthalmologist is a medical doctor whose field of study has to do with the eye. An ophthalmologist can perform surgeries on the eyes and may occasionally perform eye exams.

An optometrist, on the other hand, is a specialist who is certified to conduct eye exams and write prescriptions for lenses and contacts.

If you are looking for an ophthalmologist Medicare insurance company, it may be because you need surgery, are considering a procedure, or you need to follow up with an ophthalmologist about something that’s happened.

If that’s the case, some of your visits will likely be covered by Medicare insurance. Routine visits with an optometrist, however, will not be covered by Medicare.

Why doesn’t Original Medicare cover eye exams?

Typically, Medicare does not cover annual eye exams that people need in order to get prescription glasses or contact lenses. However, there are a few instances in which these visits may be covered by Original Medicare.

If you experienced trauma to your eye or had a procedure done, you may need a prosthesis. If that’s the case, Medicare will cover all of your routine visits to the ophthalmologist for up to five years.

With a Medicare Advantage plan, there’s a chance your coverage may include regular eye exams. Because Medicare Advantage plans are sold by individual insurers, this will all depend on the type of plan you purchased.

While ophthalmologist Medicare Advantage insurance rates vary from one company to the next, you can do some research to find ophthalmologists that accept Medicare or Medicare Advantage plans near you.

How can I find the best ophthalmologist that accepts Medicare near me?

As with most searches, one of the best ways to find the best ophthalmologists near you is to research online. This way, you can see what others have to say about the doctors near you and read their reviews online.

Online research is also the best way for you to buy Medicare Advantage insurance that will cover an ophthalmologist. You can compare companies and rates and see what works best for you.

In fact, you can use our free quote tool below to find and compare ophthalmologist Medicare insurance quotes from companies near you.

Are you looking for free insurance quotes?

Your one-stop online insurance guide. Get free quotes now!

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