Medicare routine vision coverage isn’t comprehensive; however, there is coverage for severe eye conditions. Your eyes work hard for you, and they deserve high-quality care, but is it even possible with Medicare?
We go over all the costs, coverage, and benefits of vision care. It’s essential to make sure you have everything you need in retirement; glasses might be part of that.
Below you can learn everything you need to know about Medicare vision care coverage.
Medicare Vision Coverage
Medicare excludes most routine eye exams, though it does cover conditions like glaucoma, detached retinas, and cataracts.
Glaucoma is an eye disease that affects your optic nerve, resulting in vision loss. A detachment of a retina happens when the retina tears away from the underlying tissue.
Certain health conditions or some form of trauma can lead to this severe injury. If a detached retina doesn’t correct with surgery, it can ultimately lead to a permanent loss of your vision.
Cataracts cause a cloudy lens over your eye that can create blurry eyesight. Certain chronic diseases like cataracts require surgery to repair the eye.
In a situation like this, Medicare will extend coverage to the lens replacement surgery. The doctor will remove the existing cataract and replace it with a manufactured lens.
When you have replacement surgery, Medicare covers a pair of eyeglasses or contact lenses. Also, Medicare covers exams to diagnose vision issues you may be feeling due to an eye ailment.
Medicare will provide coverage if you have diabetes or if you’re high-risk for glaucoma. However, if you aren’t high risk, paying out of pocket could be a requirement.
Does Medicare Cover Eye Exams
If you want to run into your local vision center for a simple exam to get glasses, Medicare won’t cover. You’ll be 100% responsible for the cost of your prescription eyewear, as well as your routine exam.
If you’re in the market for preventative screenings and tests to check for glaucoma or macular degeneration, you’re in luck. Medicare will cover preventative screenings to help keep the health of your eyes in check.
Not only will Medicare cover the exams for macular degeneration, but they’ll include any doctor visits to treat the disease. Once you’ve met your deductible, you can plan on Medicare paying 80%.
Medicare Vision Coverage Plans
If you’re in the market for Medicare vision coverage, a great bet is to opt into an individual plan. Individual plans allow you to acquire routine eye care at a price that you can afford.
Does Medicare Cover Cataract Surgery
If a doctor performs surgery using either lasers or traditional techniques, Medicare will cover your cataract surgery.
What sort of costs can you expect to pay? As a beneficiary, you’ll pay 20% of the health care costs after meeting the Part B deductible.
Depending on where you have your surgery, you could also be responsible for a copayment.
Does Medicare Cover Lasik Surgery
Lasik is a procedure that treats farsightedness, astigmatisms, and nearsightedness in the eyes. It’s a surgery that uses a laser and is virtually pain-free for patients.
Lasik surgery is the most common eye surgery and has proven to improve eyesight, immediately following the procedure drastically. Most times, Medicare will not pay for the eye exam given before a Lasik procedure.
Common FAQ’s About Medicare Vision Coverage
Do Medicare Advantage Plans Cover Cataract Surgery?
Surgeries to remove cataracts from the eyes are covered under Medicare if done with a traditional approach. Advantage plans can offer vision coverage.
Since private insurance carriers provide Advantage plans, they have different regulations than Medicare. Legally, Advantage plans have to offer all the benefits that Parts A and B offer.
Above the minimum benefits provided, these plans can provide even more advantages, such as routine eye exams.
As a beneficiary, you may be responsible for coinsurance or copayments associated with your eye exams. You’ll more than likely need to visit with a doctor within your network.
Most Advantage plans provide drug coverage, which can be beneficial for any medications or eye drops you need.
Does Medicare Cover Eye Exams for Cataracts?
If you suspect a problem with your eyes, Medicare covers exams to diagnose any complications. Those that have trouble with vision, severe pain, or anything out of ordinary need to contact a doctor.
Even if your diagnostic exam shows that there is nothing wrong with your eyes, Medicare still covers the exam.
If services are inpatient, Part A benefits will cover. Outpatient benefits have coverage under Part B.
Does Medicare Pay for Glasses?
Eyewear, like contact lenses or glasses, aren’t covered through Medicare; however, if you require corrective lenses because of cataract surgery, Part B will cover these lenses.
Does Medicare Cover Eye Doctors?
Medicare won’t cover the use of eye doctors for simple eyewear gear and regular eye care.
Need a doctor to treat diabetes-related vision issues or glaucoma-related issues? Part B will cover the medically-necessary exams once every 12 months with a state-certified doctor.
Do you have an accidental eye injury? Medicare extends coverage so that you’re able to get a diagnostic exam.
During these diagnostic check-ups, you’ll be able to learn the extent of your eye injuries.
Medicare Supplement Vision Coverage
Just like Medicare, Medigap plans don’t cover routine eye care. They are, however, a fantastic source in contributing towards those pesky out-of-pocket costs you come across.
In some instances, Medigap policies cover coinsurance, copayments, and deductibles Medicare covers. Want more information on how coverage can work for you and your eyesight? Give our team a call today.
We can compare rates and make sure you’re getting the most out of your coverage. If calling now is impossible, fill out our online rate comparison form to get started today!