How Medicare Takes Care of Your Eye Health

Medicare, Australia’s public health care system, plays an instrumental role in the overall health of Australians.

A common question among eligible Medicare cardholders is whether it covers eye tests, a critical aspect of maintaining eye health.

To put it simply, yes, Medicare does cover eye tests, but with certain conditions.

Let’s find out what optometry health services Medicare covers, and when it may be worth joining a private health fund for extra optical benefits.

Eye Examinations and Medicare: What’s Covered?

Eye tests are crucial for diagnosing and managing eye conditions like glaucoma, macular degeneration, myopia (short-sightedness), and dry eye.

Medicare typically covers one bulk billed eye test every three years for individuals under the age of 65 years old. If you’re over 65, you’re entitled to a bulk billed eye test annually.

Beyond eye exams, Medicare may provide coverage for certain types of eye surgery and treatments for eye diseases. However, this is dependent on your particular vision problems and the best way to know what Medicare benefits include is by consulting with your optometrist or an ophthalmologist.

How Does Medicare Cover Eye Examinations?

Most often, optometrists or ophthalmologists will directly bill Medicare for the bulk billed eye test, resulting in no out-of-pocket costs for eligible Australian permanent residents.

If your eye doctor doesn’t bulk bill, you can claim a Medicare rebate after paying your bill.

Does Medicare Cover Contact Lenses & Prescription Lenses?

While Medicare covers eye exams, it doesn’t usually include coverage for contact lenses or eyeglasses.

This is why countless Australians choose to take out optical extras cover.

With the right health insurance, you could get 2 x pairs of prescription glasses (one pair of glasses and one pair of prescription sunnies) with no gap to pay each year.

CHI TIP: If prescription glasses or contact lenses are necessary following an eye surgery that Medicare covers, the health fund may offer some rebate.

When to Book an Appointment with an Optometrist?

Eye problems don’t always present noticeable symptoms.

Regular eye tests are a proactive measure to maintain eye health, especially if you have a family history of eye disease.

If your optometrist bulk bills, you can reduce your out-of-pocket expenses.

But really, the best way to save on your eye care is with optical extras coverage.


Does Medicare cover prescription glasses?

Medicare doesn’t typically cover prescription glasses. However, if they’re required after a Medicare-covered eye surgery, you might be eligible for a rebate.

Can I get a bulk billed eye test even if I’m under 65 years old?

Yes, Medicare allows for a bulk billed eye test every three years for individuals under 65 years old.

What if my optometrist doesn’t bulk bill?

If your optometrist doesn’t bulk bill, you’ll have to pay the bill initially. You can later claim a Medicare rebate for part of this cost.

Can private health insurance provide additional coverage for eye care?

Yes, private health insurance or health funds often provide coverage for eyewear, which is not typically covered by Medicare.

Are eye surgeries covered by Medicare?

Some eye surgeries are covered by Medicare. Consult your optometrist or ophthalmologist to understand your coverage.

Need More Out of Your Eye Care? Consider Optical Extras Cover

Remember, eye care is an essential part of overall health care.

Regular eye tests, proper eyewear, and attention to any vision problems can contribute to maintaining your eye health.

Whether you’re dealing with myopia, retinal conditions, or looking to prevent future eye conditions, having the right health insurance cover can greatly reduce the financial strain of taking care of your eyes.

If you’re searching for optical cover but are overwhelmed by all the choices available, don’t worry, we can help! Simply use our free online tool below to get personalised optical cover quotes from Australia’s leading health fund providers in minutes.