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Having good eyesight is really important for our daily activities, helping us to see and fully experience the world around us. And even though Original Medicare is a vital part of healthcare for people over 65, it usually doesn’t pay for things like glasses or regular eye exams that are important to keep our eyes healthy. But there are a few situations where Medicare Part B can provide some assistance with these services.

Medicare Part B (also known as Medical Insurance) can help you cover the cost of eyeglasses if you need cataract surgery that implants an intraocular lens. With this coverage, Original Medicare beneficiaries can receive one pair of standard frame eyeglasses or a single set of contact lenses. Once you pay your Part B deductible, you’ll be responsible for 20% of the Medicare-approved amount after each cataract surgery.

When it comes to more routine vision care, like annual eye exams or eyeglasses to correct vision, consider a Medicare Advantage (Part C) plan. They offer bundled coverage that includes vision care to help maintain or correct your eyesight.

Does Medicare Cover Eye Exams?

As is the case for eyeglasses coverage, Original Medicare doesn’t usually include routine eye exams that are designed to test or correct your vision. Once again, Medicare Part B can help you cover some of these costs.

Part B may help cover medical exams that are made to diagnose and treat specific eye disorders, such as diabetic retinopathy and glaucoma. A Medicare Part B plan will pay for glaucoma screenings once every 12 months, especially if you’re considered high risk for developing the progressive eye disease. Some of these high-risk factors include:

  • You currently have diabetes.
  • You have a family history of glaucoma.
  • You’re African American and age 50 or older.
  • You’re Hispanic and age 65 or older.

Medicare may also cover certain eye exams that need to be performed before you have cataract surgery to determine the correct type of intraocular lens to be implanted.

Eye Conditions Medicare Covers

So, are there other special medical conditions that Medicare will cover? The short answer is yes. In addition to glaucoma and diabetes, Medicare Part B can provide coverage to treat additional eye conditions, including:

  • Cataracts
  • Macular degeneration
  • Infections or injuries
  • Retinal detachment

No matter if you are affected by poor vision or ill health, Medicare can help you on your journey toward improved eye health.

Other Solutions to Vision Coverage

Even though Medicare doesn’t cover routine vision care, like regular eye exams, you still have plenty of choices that can help reduce the high cost of eye care. Medicare Advantage (Part C) plans offer bundles with coverage for additional vision care. This may include:

  • Annual eye exams to check for changes in vision
  • Eyeglasses and contact lenses
  • Prescription sunglasses
  • LASIK surgery

Another option to think about is a Flexible Spending Account (FSA), which lets you set aside money before taxes to cover your healthcare costs, including those related to your eyes. There are even discount vision programs available that can offer reduced costs on eye exams, eyeglasses and contact lenses at participating providers.

Overall, it’s important to know that Original Medicare mainly focuses on eye treatments and procedures that are seen to be medically necessary, instead of regular check-ups and vision correction. To find the coverage that suits you best, get in touch with Medicare and your own healthcare or vision provider. Your eyes are your windows to the world. They help connect you to the people and experiences that matter most. Make sure you’re doing everything you can to take care of them.

Contact us today for more information on how a Wellcare Medicare Advantage plan can help with your vision care needs.

Preguntas frecuentes

Does Medicare cover anything for the eyes?

While Medicare doesn’t cover traditional eye exams, eyeglasses or contact lenses, Medicare Part B (Medical Insurance) does help to pay for corrective lenses if you have cataract surgery or for exams designed to diagnose and treat specific medical conditions, including diabetes and glaucoma.

What part of Medicare covers eyeglasses?

Medicare Part B (Medical Insurance) can cover eyeglasses or contact lenses in the event of cataract surgery. Medicare Advantage (Part C) offers bundled plans that include vision benefits in their coverage.

How often will Medicare pay for glasses?

Medicare Part B will only provide coverage for glasses if you’ve had cataract surgery. For routine eye care, including eyeglasses for vision correction, you’ll need a Medicare Advantage plan.

Are glasses lenses covered by Medicare?

Medicare Advantage plans offer coverage for eyeglasses or contact lenses to correct vision.

Are progressive lenses covered by Medicare?

No, progressive lenses are not covered by Original Medicare. It will only provide coverage for glasses in the event of cataract surgery.

Which Medicare part provides coverage for artificial eyes?

Medicare Part B, which provides medical insurance, typically covers the cost of surgically implanted artificial eyes (ocular prostheses) that are necessary due to the removal of an eye. But for Medicare to provide coverage for your prosthetic device, you must go to a Medicare-enrolled supplier, no matter if it’s you or your provider that’s submitting the claim.

Does Medicare cover low vision equipment?

Medicare Advantage plans may help to pay for certain low vision devices, but it varies among plans.

Does Medicare pay for glasses at Costco?

While Costco Optical does accept Medicare plans, Original Medicare does not provide coverage for glasses designed to correct vision.

 

Which Medicare Advantage Plan is right for you?

Call us today to learn more and enroll.

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Sources

Medicare.gov - Eyeglasses & Contact Lenses

Medicare.gov - Routine Eye Exams

 

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Y0020_WCM_134133E_M Last Updated On: 3/20/2024