Does Medicare Cover Eyeglasses?
It’s common for people over the age of 65 to experience gradual vision deterioration. In fact, there are millions Americans living with some degree of visual impairment – and 65 percent of them are over the age of 50.
Some common vision changes that older adults experience are:
- Difficultly seeing objects that are close
- Difficulty distinguishing differences in colors (like black from blue, red from orange, etc.)
- Difficulty adjusting to changing levels of light (like walking into a dark room from outside.)
Fortunately, these are vision problems that can be corrected either by wearing prescription eyeglasses or contact lenses. If you’re already wearing prescription lenses and you notice changes in your ability to see, you should get your prescription checked.
Having the right prescription lenses to improve your eyesight can minimize your risk for falls and injuries, as well as improve your life in general. If you have Medicare insurance, you may be wondering if your benefits will help you pay for your corrective lenses.
Here’s a look at how your Medicare benefits might cover prescription eyewear for you.
Does your Medicare coverage include paying for eyeglasses?
If you have coverage through Original Medicare Parts A and B, your benefits don’t typically cover routine vision care, prescription eyeglasses or contact lenses.
On the other hand, if you have cataract surgery and an intraocular lens is implanted, Original Medicare Part B (medical insurance) covers corrective lenses needed after surgery. This coverage allows you to get one pair of eyeglasses with standard frames and corrective lenses or one set of contact lenses.
If you are eligible for this coverage, Medicare Part B pays for 80 percent of the final approved cost for your glasses. You pay the remaining 20 percent after meeting your annual Part B deductible. If you get upgraded eyeglass frames, you must cover any additional cost. Also, to get this benefit, you must get your eyeglasses or contact lenses from a supplier who accepts Medicare assignment.
If you have coverage through a Medicare Advantage (Part C) plan, you may have vision coverage included in your Part C policy. While all Medicare Advantage plans are required by law to include all benefits that are covered by Original Medicare Parts A and B, Part C plan providers, who are private insurance companies working with Medicare, have the option to also offer extra benefits. Many Part C plans on the market today include extras like routine dental, hearing, and vision care.
Each Medicare Advantage plan has the right to choose what vision care it covers and how much coverage it provides. Many plans have a cap on the amount it pays toward eye care and eyewear, and you may have certain restrictions concerning the type of eyewear allowed. Today, most plans typically cover the following benefits:
- Prescription eyeglasses
- Contact lenses
- Eyeglass frames
- Fitting appointments for glasses or contacts
- Replacement lenses and frames
- Routine eye examinations
- LASIK surgery in some instances that are certified as medically necessary and depending on the type of plan you have.
Depending on the type of Medicare Advantage coverage you have, your provider might require that you use opticians, ophthalmologists, and suppliers that are included in the plan’s network of providers. If you aren’t sure about these restrictions, call your provider and ask for details before you make any appointments for your vision care, or before ordering eyeglasses or contact lenses.