Medicare and Eye Care: Discover the Coverage You Didn’t Know About!

When it comes to Medicare coverage, many people are unsure whether their vision needs like glasses and contact lenses are covered. While Medicare is a crucial health benefit for millions of Americans, it doesn’t always extend to routine vision care. Here’s a breakdown of what Medicare covers, and where you might need to look for additional help.

Does Medicare Cover Glasses or Contact Lenses?

For the most part, Original Medicare (Parts A and B) does not cover routine eye care, including the cost of eyeglasses or contact lenses. However, there are a few important exceptions.

Coverage After Cataract Surgery

One key exception is after you undergo cataract surgery, where Medicare might step in. If you have cataract surgery and get an intraocular lens implanted, Medicare Part B will cover one pair of eyeglasses or one set of contact lenses. This is one of the few scenarios where Medicare will help with vision-related costs.

But don’t forget—there are still some costs you’ll need to pay. You’ll be responsible for 20% of the Medicare-approved amount for the glasses or contacts, and you’ll also need to meet your Part B deductible. Plus, it’s essential to make sure you purchase the eyewear from a Medicare-enrolled supplier to ensure coverage.

Routine Eye Exams and Eyewear

Medicare does not cover routine eye exams, which are typically necessary to get prescriptions for glasses or contact lenses. So, if you’re just getting your eyes checked for new glasses or contacts, you’ll need to pay for it yourself. That can be a big out-of-pocket expense for many people.

Medicare Advantage Plans May Offer More Coverage

If you’re enrolled in a Medicare Advantage plan (Part C), your coverage may be different. These plans are offered by private insurers approved by Medicare and often come with extra benefits that Original Medicare doesn’t provide. Some Medicare Advantage plans might offer coverage for routine eye exams, glasses, or even contact lenses, depending on the plan. So, it’s always a good idea to review the specifics of the plan you’re considering to see if it includes vision care.

What If You Don’t Have Coverage for Eyewear?

If Original Medicare doesn’t cover your eyewear, or if you don’t have a Medicare Advantage plan, you still have other options. Many community organizations and nonprofit groups offer free or low-cost eyeglasses. Local health departments may also have programs to help with the cost. It’s worth exploring these alternatives if you’re struggling to pay for glasses or contacts.