As we age, our vision tends to deteriorate. By age 65, close to 75% of all people require some kind of vision correction. However, Original Medicare typically does not cover eye exams or glasses.
There are certain situations in which Medicare beneficiaries may receive coverage for glasses or eye exams. Still, they must first meet specific criteria and receive approval through prior authorization. Below, we review these instances and how to receive additional coverage for routine eye exams and glasses.
Does Medicare Cover Glasses and Eye Exams?
There are few circumstances where Original Medicare will cover glasses, contact lenses, or eye exams. However, do not count on Original Medicare for ordinary vision coverage.
Do Medicare Advantage Plans Cover Glasses?
When enrolling in a Medicare Advantage plan with vision benefits, be sure to review the level of coverage before deciding on a plan. Some plans may offer only basic benefits, while others offer more extensive coverage.
It is important to understand the plan’s maximum benefit. All Medicare Advantage plans with vision coverage typically have a maximum benefit for glasses and eye exams. This means once the insurance company exceeds the benefit amount, you will be responsible for 100% of costs for glasses or eye exams.
Do Medicare Supplement Plans Cover Glasses?
If you enroll in a Medicare Supplement plan, you are not out of coverage options when it comes to glasses and eye exams. Stand-alone vision plans are available to cover these benefits and others. Many stand-alone plans also offer coverage for additional services like hearing aids and dental care.
Several top Medicare Supplement carriers offer stand-alone vision plans. If you are seeking coverage, a licensed agent can review the plans available in your area and help choose the best coverage for your needs.
Does Medicare Cover Glasses After Cataract Surgery?
If you receive cataract surgery, Original Medicare may cover glasses or contact lenses from an approved supplier. In this case, Medicare Part B will cover 80% of the cost of contact lenses or glasses. However, the beneficiary will be responsible for the full cost of upgraded frames or additions to basic lenses.
If you receive cataract surgery on one eye, both eyes will be covered for glasses and contact lenses. However, to receive this coverage, the doctor who performed your cataract surgery must sign a prescription.
Also, it is important to be sure Medicare approves your supplier. If you receive glasses or contacts from a supplier who does not accept Medicare, you will be responsible for all costs.
How to Get Help with Medicare Coverage for Glasses
If you are seeking coverage for glasses and eye exams but are not sure where to begin, we can help. At MedicareFAQ, our licensed agents are experts in helping clients enroll in the best coverage for their needs. We review all plans available in your area to determine your best option.
We’re here to help! Give us a call at the number above or complete our online rate form to get started.