Does Medicare Cover Vision Care?
In general, Original Medicare (also called Part A and Part B) doesn’t cover the costs of routine eye care (such as eye exams, eyeglasses, or contact lenses). However, there are some instances when Medicare covers diagnostic and preventive eye care. The answer to the question of whether Medicare covers vision is not always a straightforward one, so specific details are provided below.
What Eye Care Does Medicare Cover?
Medicare will generally cover the following services:
- Eye exams and treatments for those with or at high risk of glaucoma, cataracts, or macular degeneration
- Yearly screenings and preventive treatments for those with diabetes
- Treatment of infection or injury to the eye
- Specialized lenses prescribed by your doctor to help your vision if you’ve had cataract surgery
- One pair of glasses or contact lenses after you have had a cataract procedure involving an intraocular lens
Medicare will cover 80% of the costs if you qualify for coverage in these cases (as long as you have paid your yearly Part B deductible), and you will be responsible for paying the remaining 20% out-of-pocket. You will also be responsible for paying a copayment if these procedures are performed in an outpatient facility.
What Eye Care Is Not Covered?
Medicare rarely covers routine vision care such as:
- Eye exams for updating eyeglasses or contact lens prescriptions
- Glasses or contact lenses
- Lasik surgery and other corrective vision treatments
Medicare will not cover the costs associated with routine eye exams and eyewear, but some exceptions exist. Be sure to check with your doctor first and review your Medicare plan carefully so you can make the most informed decision about your vision care coverage.
How Can I Get Vision Coverage?
Option 1: Consider enrolling in a Medicare Advantage plan for better vision coverage. These plans often include vision benefits, like routine eye exams and eyewear coverage. Plus, many vision specialists participate in Medicare Advantage programs, making it more straightforward to find an in-network provider.
But before choosing a Medicare Advantage plan specifically for vision coverage, you’ll want to research. There may be restrictions on what your plan will cover, such as a limit on the number of eye exams, or the plan may have a separate premium. It’s essential to read the fine print and understand the costs involved.
Option 2: If you do not want to purchase an Advantage plan, you can enroll in a stand-alone vision insurance plan offered by companies such as Cigna, Aetna, and Mutual of Omaha.
Medicare covers specific vision diagnostic and preventive services, such as glaucoma screenings and cataract surgeries. However, original Medicare does not cover routine care, such as eye exams or eyeglasses.
To get more comprehensive coverage for your vision needs, you may want to consider enrolling in a Medicare Advantage plan or a stand-alone vision plan. Be sure to read the fine print and understand what is covered under your specific plan.
Does Medicare cover eyeglasses in 2024?
In 2024, eyeglasses will not be covered by Original Medicare. But, some Medicare Advantage plans may provide coverage for vision care services, including eyeglasses. It would be best to check with your plan to determine which services are covered.
Does Medicare cover eye exams for glaucoma?
Yes, Medicare covers a glaucoma eye exam once every 12 months for those considered at high risk for glaucoma. You must be enrolled in Original Medicare (Part A and Part B). Glaucoma screenings are covered under preventive services (billed under Part B) and diagnostic services (billed under Part A or B, depending on the provider).