Most Asked Questions on Eye Test with Medicare

How much does an eye test cost? How does Medicare help you book free eye tests? Does Medicare cover the cost of all eye tests and medical procedures? While you fix up your mind to sign for Medicare you have several questions that confuse you. But don’t panic, we are here with all the answers to the commonly asked questions you’re looking for. Let’s delve deep into each of them to understand all about Medicare and its benefits.

What is Medicare?

Whether you wear a prescription eyeglass for vision correction or not, some people have an ongoing eye disease such as diabetes, permanent kidney failure, certain disabilities at a young age or elderly people who require regular eye examination. To address their need, Medicare – a federal insurance program typically covers the cost for a variety of health care services including emergency, preventive and long term insurance.

How much does an eye test with Medicare cost?

Medicare covers the cost of various chronic optometry treatment and services for permanent residents of Australia. Anyone with a Medicare card can claim this insurance. if you are under 65, you can be seen under Medicare once every 3 yr and for 65 and older, Medicare can be claimed every year.

Meanwhile, Medicare does not pay for routine contacts and eyeglasses, they only subsidise eye examination and treatment.

What is bulk billing:

When you visit an optometrist for an eye check-up under the Medicare plan, they will bill the government against the cost of your treatment, here you don’t have to pay anything for the expenses of treatment and test. This is known as bulk billing.

On the other hand, if your optometrist does not bulk bill, you need to claim the Medicare benefits yourself to pay the cost of your test and treatment.

Does Medicare cover all eye tests?

Generally, Medicare doesn’t cover you for the routine eye check-up. However, they will get you covered under vision care necessary facilities required, when you qualify for any of these:

  1. If you are diabetics, Medicare will cover you for an annual eye test for vision-related problems caused by chronic disease.
  2. You are covered for free glaucoma tests, when you are at high risk of glaucoma due to family medical history, have diabetes, 50 yrs or over African American and 65 or older Hispanic.
  3. Macular degeneration tests and treatment cost, when you or your doctor suspect the disease caused due to ageing.
  4. Surgical procedure when undergoing a Cataract surgery. It pays for the charges of removing the cataract and replacing it with the intraocular lenses.

Does Medicare pay for optical glasses and contacts?

Generally. Medicare services do not pay for vision care. The cost of prescription glasses and contact lenses are only covered in the Medicare plan when you have intraocular lenses implanted in the eye after the cataract surgery. In this case, you can claim for the single pair of corrective prescription glasses suggested by the optometrist.

Note that this is a single time benefit, if your prescription changes after a while, Medicare doesn’t pay for the change in prescription.

Where do I need to have my eye tested?

Even if you wear prescription glasses or not, it is important to have your eye tested regularly to ensure their good health. You can visit any registered optometrist for an eye test if you notice any vision change. Meanwhile, your general physician can also refer to a good eye doctor, when he finds any sign of underlying eye diseases.

Have more questions on Medicare coverage and free eye tests? Ask us now, we are happy to answer any questions.


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