Medicare provides vision coverage in much the same way it handles dental care—offering assistance for a few major needs but not covering routine services.

Let’s start with eye exams, often called eye refractions. Medicare generally doesn’t pay for routine checkups unless a serious condition is suspected. For instance, it covers a glaucoma screening once every 12 months, but only for high-risk individuals. High-risk groups include people with diabetes, those with a family history of glaucoma, African Americans aged 50 and older, and Hispanic Americans aged 65 and older.

Medicare also covers certain diagnostic tests and treatments if you are diagnosed with macular degeneration.

When it comes to eyeglasses and contact lenses, coverage is rare. However, if you undergo cataract surgery with an intraocular lens implant, Medicare will pay for one pair of eyeglasses or contact lenses. This is a one-time benefit, with restrictions on the type of frames covered.

Finally, Medicare covers eye prostheses for individuals who have lost or experienced shrinkage of an eye due to birth defects, trauma, or surgery. Replacements are covered every five years.

All these services are included under Medicare Part B. For each, the Part B deductible applies, and you’ll be responsible for 20% of the Medicare-approved cost.