Does Medicare Cover Macular Degeneration? Tests, Injections, and Costs

What Medicare covers for macular degeneration

Macular degeneration care falls under Medicare Part B (medical insurance), not Part D. That is because the main treatments are given by a doctor in an office or clinic, and Part B is the part of Medicare that covers doctor-administered drugs and physician services.

Part B may cover certain diagnostic tests and treatments if you have age-related macular degeneration (AMD). This is true whether you have Original Medicare or a Medicare Advantage (Part C) plan, because every Medicare Advantage plan must cover at least the same AMD tests and treatments as Original Medicare.

• Diagnostic tests to find and monitor AMD, such as imaging scans your eye doctor uses to look at the retina.
• Anti-VEGF eye injections for wet AMD, including ranibizumab (Lucentis), aflibercept (Eylea), and approved biosimilars, billed as Part B drugs.
• Ocular photodynamic therapy (OPT) with the drug verteporfin, which Medicare covers nationwide under a national coverage decision.
• The doctor's services connected with examining, diagnosing, and treating your AMD.

What you'll pay in 2026

With Original Medicare, your share of AMD treatment follows the standard Part B cost-sharing rules. In most cases, after you meet the Part B deductible, you pay 20% of the Medicare-approved amount for both the drug and your doctor's services.

If you get treatment in a hospital outpatient department instead of a doctor's office, you also pay a separate facility copayment on top of the 20%.

Here are the 2026 Part B figures that apply:

• Part B annual deductible: $283 — you pay this once per year before the 20% coinsurance starts.
• Part B coinsurance: 20% of the Medicare-approved amount for AMD drugs and services after the deductible.
• Part B standard monthly premium: $202.90 (higher earners pay more through IRMAA). You must keep paying the premium for Part B to cover your AMD care.
• Because wet AMD often means repeat injections over time, the 20% can add up. There is no annual out-of-pocket limit under Original Medicare alone, which is why many people add a Medigap policy (see below).

Tests and treatments in detail

Wet AMD is most often treated with anti-VEGF injections into the eye. Medicare Part B covers these drugs — including Lucentis (ranibizumab), Eylea (aflibercept), and approved biosimilars — when they are given for retinal disease such as AMD in keeping with the standard of care. Because the drug is given by your doctor, it is paid under Part B, not your Part D drug plan.

Medicare also covers ocular photodynamic therapy with verteporfin for AMD under a national coverage determination. This is a treatment your retina specialist may use in specific cases.

For dry AMD and the advanced form called geographic atrophy, newer injectable drugs have come to market. Coverage for any specific drug depends on FDA approval, how the drug is administered, and current Medicare coverage rules. Because these can change, ask your retina specialist whether the exact drug they recommend is covered by Medicare before you start treatment.

• Your doctor may sometimes recommend services more often than Medicare covers, or services Medicare doesn't cover at all. If that happens, you may pay some or all of the cost.
• Before any procedure, ask your eye doctor's office exactly what Medicare will approve and what you will owe.

What Medicare does NOT cover

Even though Medicare covers AMD treatment, several related items are not covered by Original Medicare:

• Routine (refraction) eye exams for prescribing glasses are not covered, even if the visit also checks for AMD.
• Eyeglasses and contact lenses are usually not covered. The one exception is after cataract surgery that implants an intraocular lens — then Part B covers one pair of standard eyeglasses or one set of contact lenses (you pay 20% after the deductible, plus any cost for upgraded frames).
• Over-the-counter AREDS or AREDS2 antioxidant eye vitamins are not covered, because Medicare generally does not pay for over-the-counter products.
• Most low-vision aids and magnifiers are not covered by Original Medicare, though a Medicare Advantage plan may offer extra help — check your plan.

Medicare Advantage and Medigap

If you have a Medicare Advantage (Part C) plan, it must cover the same AMD tests and treatments as Original Medicare, but your copays, network rules, and prior-authorization requirements can differ. Many Advantage plans also add extra benefits Original Medicare doesn't cover, such as routine vision exams and an eyewear allowance — but these extras vary by plan, so confirm the details in your plan's Evidence of Coverage.

If you stay with Original Medicare, a Medigap (Medicare Supplement) policy can help pay the 20% Part B coinsurance you would otherwise owe on every injection and office visit. For someone facing ongoing AMD injections, Medigap can turn unpredictable bills into a more steady, predictable cost. The exact coverage depends on which Medigap plan letter you buy.

• Medicare Advantage: same core AMD coverage required; copays and extra vision benefits vary by plan.
• Medigap: helps cover the Part B 20% coinsurance and other gaps; works only with Original Medicare, not with Medicare Advantage.