Quick Answer
Yes, Medicare Part B covers medically necessary macular degeneration treatments. This includes anti-VEGF injections (such as Eylea, Lucentis, and Avastin), laser photocoagulation, and photodynamic therapy (PDT). Routine eye exams and eyeglasses are not covered by Original Medicare, but treatments for diagnosed eye diseases are. You pay 20% coinsurance after the $283 Part B deductible.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Medicare Part B (Outpatient) | Covered | Covers anti-VEGF injections, laser therapy, PDT - 80% after $283 deductible |
| Medicare Part A (Inpatient) | Limited | Covers treatment if performed during a qualifying hospital inpatient stay |
| Medicare Advantage (Part C) | Covered | Must cover same services as Original Medicare; may include extra vision benefits |
| Medicare Supplement (Medigap) | Varies by Plan | Covers some or all of the 20% coinsurance left by Part B |
Understanding Your Coverage Options
Original Medicare (Part B)
Covered when medically necessaryMedicare Part B covers treatments for macular degeneration because they are medically necessary to prevent or slow vision loss - a diagnosed medical condition. This is an important distinction: Medicare does not cover routine eye exams or eyeglasses, but it does cover treatment for eye diseases like macular degeneration, glaucoma, and diabetic retinopathy.
The most common treatment for wet age-related macular degeneration (AMD) is anti-VEGF (vascular endothelial growth factor) injections. These drugs - including Eylea (aflibercept), Lucentis (ranibizumab), and Avastin (bevacizumab, used off-label) - are injected directly into the eye by a retinal specialist. Because they are physician-administered drugs, they are covered under Part B rather than Part D.
Medicare also covers laser photocoagulation (for certain types of AMD) and photodynamic therapy (PDT) with Visudyne for wet AMD. Diagnostic imaging such as optical coherence tomography (OCT) and fluorescein angiography used to monitor the condition are also covered.
What It Covers
- Anti-VEGF injections: Eylea, Lucentis, Avastin (off-label), Beovu, Vabysmo
- Laser photocoagulation for certain AMD types
- Photodynamic therapy (PDT) with Visudyne
- Optical coherence tomography (OCT) scans
- Fluorescein angiography for diagnosis and monitoring
- Retinal specialist office visits
- Low vision aids (in limited circumstances)
What It Doesn't Cover
- Routine eye exams (not related to a diagnosed eye disease)
- Eyeglasses or contact lenses (except after cataract surgery)
- Dry AMD treatments (no FDA-approved treatment currently exists)
- Vitamins or supplements (such as AREDS2 formula)
Part B covers 80% of the Medicare-approved amount for anti-VEGF injections. You pay 20% coinsurance after the $283 annual deductible. Anti-VEGF injections can cost $1,000–$2,000 per injection, meaning your 20% share could be $200–$400 per injection without a supplement.
Medicare Advantage (Part C)
Covered - may include extra vision benefitsMedicare Advantage plans must cover all macular degeneration treatments covered by Original Medicare. Many plans also offer supplemental vision benefits that go beyond Original Medicare, such as coverage for routine eye exams and eyeglasses - benefits that Original Medicare does not include.
If you have macular degeneration and are considering a Medicare Advantage plan, check both the medical coverage (for treatments) and the supplemental vision benefits (for exams and glasses). Make sure your retinal specialist is in the plan's network.
What It Covers
- All anti-VEGF injections and other AMD treatments covered by Original Medicare
- Routine eye exams (as a supplemental benefit on many plans)
- Eyeglasses or contact lens allowance (as a supplemental benefit on many plans)
- Retinal specialist visits
What It Doesn't Cover
- Out-of-network retinal specialists (unless plan has out-of-network benefits)
- Treatments not pre-authorized by the plan
Look for Vision Supplemental Benefits
Many Medicare Advantage plans include routine vision coverage (exams + eyeglasses) as a supplemental benefit. If you have macular degeneration, compare plans that offer both strong medical coverage and vision benefits.
Medicare Supplement (Medigap)
Covers some or all of Original Medicare's cost-sharingMedigap plans can significantly reduce the cost of ongoing macular degeneration treatment. Because anti-VEGF injections can be needed every 4–8 weeks, the 20% Part B coinsurance adds up quickly over the course of a year.
With Medigap Plan G, after paying the $283 annual Part B deductible, you pay nothing for covered macular degeneration treatments. This can save hundreds or even thousands of dollars per year for patients receiving regular injections.
What It Covers
- Part B coinsurance (20%) - covered by most Medigap plans
- Part B deductible - covered by Plan C and Plan F (for those eligible before Jan 1, 2020)
- Part A deductible - covered by Plans D, G, and others
What It Doesn't Cover
- Routine eye exams (not covered by Original Medicare, so not covered by Medigap)
- Eyeglasses or contact lenses
- Dry AMD supplements (AREDS2 vitamins)
With Medigap Plan G, your only out-of-pocket cost for anti-VEGF injections is the $283 annual Part B deductible. Without a supplement, you could pay $200–$400 per injection in coinsurance.
Estimated Macular Degeneration Treatment Costs under Medicare (2026)
| Treatment | Frequency | Your Cost (No Supplement) | Your Cost (With Plan G) |
|---|---|---|---|
| Anti-VEGF injection (Eylea, Lucentis) | Every 4–8 weeks | ~$200–$400 per injection (20% coinsurance) | $0 after $283 annual deductible |
| Anti-VEGF injection (Avastin, off-label) | Every 4–8 weeks | ~$10–$30 per injection (20% coinsurance) | $0 after $283 annual deductible |
| OCT scan (monitoring) | Every 1–3 months | 20% coinsurance after deductible | $0 after $283 annual deductible |
| Photodynamic therapy (PDT) | As needed | 20% coinsurance after deductible | $0 after $283 annual deductible |
✦ What Medicare Does not Cover for Eye Conditions
Routine Eye Exams and Eyeglasses
Original Medicare does not cover routine eye exams, eyeglasses, or contact lenses. These are only covered by Medicare Advantage plans that include supplemental vision benefits. If you need glasses or contacts in addition to macular degeneration treatment, a Medicare Advantage plan with vision benefits may be worth considering.
Medicare does cover one pair of eyeglasses or contact lenses after cataract surgery - but this is the only vision correction benefit under Original Medicare.
Dry AMD: No FDA-Approved Treatment Covered
Dry age-related macular degeneration (dry AMD) accounts for about 85–90% of all AMD cases. As of 2026, there is one FDA-approved treatment for geographic atrophy (an advanced form of dry AMD): Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol). Medicare Part B covers these injections when medically necessary. AREDS2 vitamins, which may slow dry AMD progression, are not covered by Medicare.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.