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.
What Does Medicare Pay for Vision Care?
Original Medicare coverage excludes routine eye exams. The only coverage you will receive for vision though 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 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 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 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.
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.
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.
Does Medicare Cover Cataract Surgery?
If a doctor performs surgery using either lasers or traditional techniques, Medicare will cover your cataract surgery.
For this procedure, you pay 20% of the health care costs after meeting the Medicare Part B deductible. Those with Medigap plans pay even less.
Does Medicare Cover Lasik Surgery?
Medicare Part A and Part B do not cover Lasik procedures unless a physician deems them medically necessary. Medicare does not cover the procedure for the sake of standard vision correction.
One example of Lasik coverage by Medicare is for a traumatic injury in which Lasik could be a beneficial treatment. Lasik is a procedure that treats farsightedness, astigmatisms, and nearsightedness.
Lasik surgery is the most common eye surgery, proven to drastically improve eyesight immediately following the procedure. It is a surgery that uses a laser and is virtually painless for patients. In most cases, Medicare will not pay for the eye exam prior to a Lasik procedure.
FAQs
How to Get Help with Vision Coverage with Medicare
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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!