If diabetes runs in your family or your eye doctor mentioned glaucoma, here's the short answer: Medicare Part B covers a glaucoma screening once a year, but only for people it counts as high risk. Below, we'll walk through exactly who qualifies, what you'll pay, and how often the benefit renews.
In This Guide
- Key Takeaways
- Does Medicare Cover Glaucoma Testing?
- Who Counts as High Risk for Glaucoma?
- What Does a Glaucoma Test Cost With Medicare?
- How Often Does Medicare Cover a Glaucoma Test?
- Frequently Asked Questions
- Learn More
Does Medicare Cover Glaucoma Testing?
Short answer: yes. Medicare Part B covers a glaucoma screening test once every 12 months, but the benefit is written for people the program considers high risk, not for everyone with a Medicare card.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
Glaucoma tends to develop slowly, often without early warning signs, so a screening is how it gets caught before it does real damage. Medicare treats the test as a preventive Part B service, the same category as its other early-detection screenings. That's the good part. The part people don't expect is that "preventive" here doesn't mean "no cost," which we'll get to below.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
Who Counts as High Risk for Glaucoma?
This is the piece that decides whether the screening is covered for you. Following the federal rule at 42 CFR 410.23, Medicare covers the glaucoma screening for four groups of people at high risk:Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
- People with diabetes
- People with a family history of glaucoma
- African Americans age 50 and older
- Hispanic Americans age 65 and older
If you fall into one of those four categories, Part B will pay for the annual screening. You only need to fit one of them to qualify, and it's common for more than one to apply, say, if you have diabetes and a parent had glaucoma. Those are the groups the benefit is written for. Not sure which one fits you, or whether your family history counts? Your eye doctor can tell you, and it's worth asking before the visit so there are no surprises on the bill.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
What Does a Glaucoma Test Cost With Medicare?
A lot of people assume "preventive" means "free." For the glaucoma screening, it doesn't quite work that way.
After you meet the annual Part B deductible ($283 in 2026), you generally pay 20% of the Medicare-approved amount for the test.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles If the screening is done in a hospital outpatient setting, a separate copayment can apply on top of that.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
So your actual out-of-pocket cost depends on where you are in the year. If you've already met your deductible, you're looking at the 20% coinsurance. If you haven't, the screening counts toward the deductible first, and you'd pay more of it yourself until you hit $283.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Where you have the test done can change the bill too. In a regular doctor's office, it's the deductible and 20%. Have it in a hospital outpatient department instead, and that separate facility copayment can get added on top.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings If cost is on your mind, it's worth asking the office both what setting you'll be billed under and whether you've met your deductible yet before you go.
How Often Does Medicare Cover a Glaucoma Test?
The screening is covered once every 12 months. The federal rule builds that around an 11-month gap: you can get a new screening once at least 11 months have passed since the month of your last one, which is how the once-a-year benefit works in practice. So if your last screening was in March, you're due again the following February at the earliest.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
Medicare is also specific about who's allowed to run it. According to Medicare.gov, "an eye doctor who's legally allowed to do glaucoma tests in your state must do or supervise your screening." In practice, that means an optometrist or ophthalmologist who's licensed to perform the test where you live.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
The rule allows two setups: that eye doctor performs the test personally, or it's done under their direct supervision in the office. So the test doesn't have to be run by their own hand every second, but a qualified optometrist or ophthalmologist has to be the one responsible for it. If you're booking a screening, that's the credential to confirm the practice has.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings
Frequently Asked Questions
Does Medicare cover a glaucoma test if I'm not high risk?
Medicare's glaucoma screening benefit is built for four high-risk groups: people with diabetes, people with a family history of glaucoma, African Americans 50 and older, and Hispanic Americans 65 and older. If you're in one of those, Part B covers a screening once every 12 months. If you're not sure which category fits you, your eye doctor is the person to ask.
Is the glaucoma screening free under Medicare?
Not the way some preventive tests are. You generally pay 20% of the Medicare-approved amount after meeting the Part B deductible, which is $283 in 2026.Centers for Medicare & Medicaid Services. (n.d.). Glaucoma Test Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/glaucoma-screenings,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles In a hospital outpatient setting, a separate copayment can apply too.
Does a Medicare Advantage plan cover the glaucoma screening too?
Yes. Medicare Advantage (Part C) plans have to cover the medically necessary Part A and Part B services Original Medicare covers, so the annual high-risk glaucoma screening is included. What differs is the fine print: many plans pay in full only when you use an in-network eye doctor, and a plan may require prior authorization, meaning plan approval, before it covers the test. Your share of the cost may also be structured differently from Original Medicare's 20%. It's worth checking your plan's rules before you book.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
What if Medicare denies my glaucoma screening claim?
You can appeal. If Original Medicare denies the screening, your Medicare Summary Notice explains why, and you have 120 days from receiving it to file a first-level appeal, called a redetermination. A common reason for denial is that Medicare doesn't have you on record in one of the four high-risk groups, so it's worth confirming your eye doctor documented the risk factor that qualifies you. Medicare Advantage plans run their own appeal process that starts with the plan itself.Centers for Medicare & Medicaid Services. (n.d.). Appeals in Original Medicare. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals/original-medicare
Learn More
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.