Original Medicare routine vision coverage is not comprehensive. However, you have options when it comes to coverage for severe eye conditions. Your eyes work hard for you, and they deserve high-quality care. In some cases, this is possible with Medicare. In this article, we go over all the costs, coverage, and benefits of vision care.
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What Does Medicare Pay for Vision Care?
Original Medicare coverage excludes routine eye exams. The only coverage you will receive for vision through Medicare is to treat conditions like glaucoma, detached retinas, and cataracts.
Glaucoma is an eye disease that affects your optic nerve, resulting in vision loss. A detachment of the 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 is not corrected with surgery, it can ultimately lead to permanent vision loss.
Cataracts cause a cloudy lens over your eye that can cause blurry eyesight. Certain chronic conditions like cataracts require surgery to repair the eye. In a situation like this, Original Medicare (Medicare Part A and Part B ) will extend coverage to the lens replacement surgery. The doctor will remove the existing cataract and replace it with a manufactured lens.
Medicare covers a pair of eyeglasses or contact lenses when you have replacement surgery. In this case, Medicare will also cover exams to diagnose vision issues you may be experiencing due to an eye ailment.
Medicare will provide coverage if you have diabetes or if you are at a high risk for glaucoma. But, if you are not high-risk, paying out-of-pocket could be a requirement. There are also Medicare Supplement (Medigap) Plans available to help you cover out-of-pocket expenses for Medicare-approved healthcare.
Does Medicare Cover Eye Exams?
If you want to visit your local vision center for an annual eye exam, Medicare will not provide coverage. You will be responsible for 100% of the cost.
However, if you receive a preventive exam or test to check for glaucoma or macular degeneration, you’re in luck. Medicare will cover preventive screenings to help keep your eye health in check. Not only will Medicare cover the exams for macular degeneration, but coverage will also include any doctor visits to treat the disease.
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If you are on Original Medicare and are looking for routine eye exam coverage, you are not out of options. You can enroll in a stand-alone vision plan that offers great coverage at a low cost. There are several stand-alone plans available, and some even cover additional benefits like dental or hearing.
FAQs
How to Get Help with Vision Coverage with Medicare
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Is surgery to correct double vision covered by Medicare?
Larry, surgery to correct vision is typically not covered by Original Medicare. However, it could be covered if your physician deems it to be medically necessary.
What does it take to file for Medicare reimbursement for glasses / lenses after Cataract Surgery?
Hi Richard, Medicare helps cover the cost of corrective lenses post-cataract surgery if you have had the operation for the purpose of implanting an intraocular lens. The coverage includes one pair of glasses or one set of contact lenses.
Had eye surgery now need surgery to remove excess skin, altering my vision, Medicare has denied it, what do I have to do to correct my vision in one eye
Hi Je Je! Medicare does not cover surgeries that your doctor doesn’t deem as medically necessary. You would need to look into additional coverage outside of Medicare. However, you would still need to check if they would cover the surgery if your doctor does not say it’s medically necessary.
I would like info on vision and dental insurance. I do not want to be swamped with emails!!!!
Hi James! This FAQ discusses Medicare vision coverage, we have another FAQ that discusses Medicare and Dental coverage. Give us a call and we’ll answer any questions you have!