Skip Navigation

Toll Free & Confidential Helpline: (888) 818-2611

March 3, 2022 Health & Wellness

Does Medicare Cover Glaucoma Tests?

With World Glaucoma Week fast approaching (March 6-12, 2022), we wanted to share what Medicare covers for beneficiaries regarding glaucoma tests.

What is Glaucoma?

Glaucoma is an eye disease that usually produces increased pressure within the eye, leading to damage of the optic nerve. This can result in loss of sight over time. However, glaucoma doesn’t have to lead to blindness. Early detection, diagnosis, and treatment of glaucoma can help a person preserve their vision, so you may want to take advantage of glaucoma testing if you are at high risk for developing the disease.

Does Medicare Cover Glaucoma Tests?

Medicare Part B is the medical insurance that covers certain doctors’ services, medical supplies, outpatient care, and preventive services. Per, Medicare Part B covers one glaucoma test every 12 months for patients at high risk for glaucoma. It is important to note that the test must be done or supervised by an eye doctor who is legally allowed to do this test in your state.

If any of the following applies to you, you are considered high risk for glaucoma:

  • You have a family history of glaucoma
  • You have diabetes
  • You are age 50+ and African American
  • You are age 65+ and Hispanic

What are My Costs for Glaucoma Tests?

If you’re on Original Medicare, you will have to pay 20% of the Medicare-Approved Amount for the glaucoma test as well as a Part B deductible. If the test is done in a hospital outpatient setting like an emergency department, surgery center, or pain clinic, you’ll also have to pay a copayment. Remember, the Medicare-Approved Amount is sometimes less than the amount the doctor charges, so you’re responsible for the difference if that is the case.

The specific amount you’ll have to pay for a glaucoma test can depend on things like how much the doctor charges, where you get the test, and if you have any other insurance, so you should talk to your health care provider to find out how much it will cost.

If you are on an Advantage Plan, please check with your health care provider.

A list of the other preventive and screening services covered by Medicare Part B can be found on the website.