Original Medicare does not cover eyeglasses or contact lenses. However, according to Medicare.gov, if you have cataract surgery where an intraocular lens is implanted, Medicare may cover one set of corrective lenses.
In this post, we’ll answer your biggest questions and help you figure out exactly how to get vision coverage from your Medicare plan.
Most eyeglasses and contact lenses are “non-covered services”, and you will have to pay 100% out-of-pocket. If you qualify for Medicare and they pay for glasses or contact lenses post-cataract surgery, you will have to go to one of their chosen suppliers.
According to Medicare.gov, they will only accept a claim from a supplier enrolled in Medicare, so be careful where you get the glasses!
Does Medicare Cover Vision?
When you join Medicare, you’ll receive a basic vision test as part of your introduction. (Think of it as a sort of “welcome package.”) However, eyeglasses and contact lenses, as well as routine eye exams for these, are not covered by Medicare.
So, what is included?
- Annual eye exams for diabetics and people at risk of glaucoma.
- Functional surgery related to chronic eye conditions, such as cataracts.
- Diagnostic vision exams related to chronic eye conditions (according to Medicareinteractive.org)
- Eyeglasses or contact lenses after cataract surgery with an intraocular lens implant.
Does Medicare Cover Eye Exams?
Medicare doesn’t cover routine eye exams for eyeglasses and contact lenses. However, it does cover annual eye exams if you have diabetes, are at risk of glaucoma, or need macular degeneration testing.
Does Medicare Cover Eye Exams for Diabetes?
Yes, Medicare will cover an annual eye exam if you are diagnosed with diabetes (medicare.gov). This is to screen for any vision problems related to diabetes.
Does Medicare Cover Vision for Glaucoma?
Yes, Medicare does cover eye exams for glaucoma. If you’re considered at high risk of glaucoma, Medicare pays for one eye exam per year (medicare.gov).
Does Medicare Cover Eye Exams for Macular Degeneration?
Medicare Part B covers macular degeneration testing once your doctor suspects you may be affected and believes it needs to be treated (medicare.gov).
How often does Medicare pay for eye exams? According to medicare.gov, they pay for one simple test in the beginning and then annual eye exams if you’re diabetic or at high risk for glaucoma. But it’s important to keep in mind that you’ll only be tested for macular degeneration if a doctor thinks it’s necessary.
Does Medicare Cover Cataract Surgery?
Medicare may cover cataract surgery where an intraocular lens is implanted. They pay 80% of the cost of the procedure, so you’ll have to cover the rest (medicare.gov).
In addition to this, you may be wondering does Medicare pay for glasses after cataract surgery? According to Medicare.gov, Original Medicare (Part B) covers corrective eyeglasses or contact lenses after surgery if needed, which is helpful if you find your vision suffers after the procedure.
What’s the Best Plan With Vision Coverage for You?
Now that we’ve answered the question, “Does Medicare cover vision?” let’s get you a solid plan to make sure your eyes are taken care of. The “best” plan depends on your specific needs, and the plans available in your location. So there’s no one-size-fits-all plan for everyone.
That said, here are some of your options!
Medicare Advantage does include vision benefits. However, it also has a maximum that it will pay out for vision, so it’s important that you check that what you need is covered. For example, your plan might only cover regular lenses in eyeglasses when what you need is a set of bifocal lenses.
New Eyes helps people of all ages get access to the eyeglasses they need. You’ll need to contact a social worker or someone at a community health center.
EyeCare America may offer eye tests (as well as a year of necessary treatment) at no cost to older people at risk of glaucoma.
Lions Club International can help you pay for eyecare if you need assistance. All you need to do is contact your local club.
At the end of the day, what really matters is that you get the eye care you need to maintain your vision health. If you have the budget to pay extra for vision benefits packages or discount vision plans, that’s a good choice. However, if you’re already on Medicare, you might want to consider enrolling in a Medicare Advantage plan so you’ll have access to vision benefits.
So, basically, start by looking at what you can afford. If you have the money to pay extra for vision benefits packages or discount vision plans, then you should prioritize your vision by investing in these. But if you can’t stretch your budget that far and Medicare doesn’t offer what you need, a Medicare Advantage plan may be a good option.
And if you simply don’t have the money to spend, don’t worry, there are organizations that help. Reach out to New Eyes, EyeCare America, and Lions Club International (listed above), and you can apply for the help you need.
Want more guidance? Chat with a PlanFit-approved agent by filling out this form or using the chat widget on the bottom right of your screen. They’ll coach you through the process and point you in the right direction.