Does Medicare cover routine eye exams, glasses, or contact lenses?
No, Medicare does not cover routine eye exams.
If all you have for coverage is Medicare Parts A and B and nothing else, you will need to pay all costs for your routine eye exams, contacts, and glasses.
Does that mean you have to pay 100% of your routine vision eye care once you’re on Medicare?
No. It absolutely does not.
There are many options for saving money on your routine vision care when you’re on Medicare.
In this video, we’re going to look at several of those.
Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To…
Over 90% of Medicare beneficiaries wear eyeglasses, but Original Medicare, Parts A & B, does not cover routine eye exams, contact lenses, or glasses.
Eye conditions covered by Medicare
However, there are some eye conditions that Medicare does cover treatment for. If you have diabetes, Medicare Part B covers eye exams for diabetic retinopathy once each year.
Medicare Part B also covers glaucoma tests once every 12 months if you’re at high risk for glaucoma. Medicare will also cover treatment for glaucoma.
Medicare Part B also may cover certain tests and treatment (including treatment with certain injected drugs) of eye diseases and conditions if you have age-related macular degeneration.
Treatment for cataracts is also covered by Medicare and generally includes coverage for one pair of glasses following surgery.
Medicare covers care related to eye disease or injury.
For example, Medicare covers medically necessary treatment, such as medication or surgery, for conditions like:
• Dry eyes and allergies.
• Eyelid problems.
• Eye infections (like conjunctivitis).
• Corneal disease.
• Detached retina.
• Eye injuries.
Most treatment for these conditions is done on an outpatient basis and falls under Medicare Part B. Therefore, the Part B deductible applies. If you have already reached your deductible, your responsibility will be 20% while Medicare pays the remaining 80%.
That’s what Medicare covers.
What if you only want coverage for routine eye exams and prescription glasses or contacts?
If you are just looking for coverage for annual eye exams and prescription contact lenses or glasses, you have options of both vision insurance coverage and discount plans.
If you have a Medicare plan that doesn’t include vision coverage, you can purchase a standalone vision plan or a combination dental and vision plan. The monthly premium costs for these plans can be as low as $10 to $15 per month for just vision coverage for one individual up to well over $50 per month for a policy that covers dental and vision together.
Always look carefully at the benefits and especially the annual limits for these plans to determine whether the monthly premium cost is worthwhile.
There are also vision discount plans that may help pay your vision care costs.
There are a ton of these! You may already be eligible for vision discounts without even knowing it.
If you are an AARP member, you have vision discounts. If you are a AAA member, you have vision discounts. If you are a Costco or Sam’s Club member, you have vision discounts. If you have a Medicare Supplement plan, check the extras that came with your policy. You may already have vision discounts there.
If you don’t have any of those, you can purchase a discount vision program.
There are a bunch of these. Any online search will turn up many of them. They are usually pretty inexpensive, and although they don’t usually cover as much as regular vision insurance does, they still help you save money on routine eye exams and glasses and contact lenses.
Vision discount coupons are another option.
You can search for vision discount coupons online and use those to save on your vision care.
Also, eyeglass and contact lens manufacturers sometimes offer rebates, so that’s another way to save.
Rebate information and forms can be found through your eye doctor’s office or online.
If you have questions or concerns about your vision coverage or any other Medicare coverage questions, please feel free to call our office at 877-312-1414 or schedule a free, no obligation Medicare Plan Consultation. We’ve been here for over 40 years because we work for you.
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