Does Medicare Cover Glasses?

Does Medicare pay for eyeglasses?

As a general rule, original Medicare doesn’t pay for eyeglasses. This means that if you need a new pair of glasses, you’ll likely pay 100 percent of the costs out of pocket.

However, there are some exceptions if you have Medicare Advantage or after you’ve had cataract surgery. We’ll explore the details of these exceptions next.

Medicare Part B coverage

Medicare Part B(medical coverage) will pay for corrective eyeglass lenses after you’ve had cataract surgery with an intraocular lens implant.

However, this doesn’t mean your glasses are completely free. You will pay 20 percent of the cost for your eyeglasses, and your Part B deductible applies. A couple of stipulations include:

• you’ll pay additional costs for upgraded frames
• you must purchase the eyeglasses from a Medicare-enrolled supplier

If you lose or break these glasses, Medicare won’t pay for new ones. Medicare only pays for one new pair of eyeglasses per lifetime, per eye you have surgery on. So, if you have surgery to correct one eye, you can get a pair of eyeglasses at that time. If you have cataract surgery on another eye at a later time, you can get another new pair of eyeglasses.

Medicare Advantage coverage

Medicare Advantage(or Medicare Part C) is an alternative to original Medicare where you select a private insurance company to fulfill your Medicare benefits. AMedicare Advantage planmust offer all that original Medicare does, and some plans expand their coverage to includedental,hearing, orvisioncare.

While Medicare Advantage may offer some vision benefits, there are still out-of-pocket costs. According to a recent study, Medicare Advantage enrollees with vision coverage still paid about62 percentof the costs associated with their vision spending.

If you have Medicare Advantage with vision coverage, it’s important to use in-network providers for your vision care. Your plan may also have preferred suppliers for eyeglasses and lenses. Choosing from a list of approved providers will usually help you get the greatest cost savings.

If you choose a Medicare Advantage plan with vision coverage, your premium or deductible may be slightly higher. Your vision coverage may also require a copayment for vision services and eyeglasses purchases. With other plans, you must meet your deductible before your plan will pay a portion of your vision services. However, if you think you’ll need frequent vision services, a plan with vision coverage might save you money in the long run.

To find a Medicare Advantage plan that offers vision coverage, you can use theFind a Medicare Plansearch tool. You can also contact Medicare Advantage plans and companies directly to ask questions about their vision coverage.

Medigap

Medicare supplement insurance, orMedigap, is a supplemental insurance policy you can purchase if you have original Medicare. While Medigap can help pay for out-of-pocket costs associated with Medicare parts A and B, such as coinsurances and deductibles, it won’t help pay for “extras” like vision care.

What is not covered by Medicare for vision?

Medicare doesn’t cover the following services related to vision care:

• routine eye exams
• purchase of eyeglasses
• purchase ofcontact lenses
• purchase of upgraded lenses

However, Medicare Part B does cover some vision screenings, including an annual glaucoma test for those at risk and an annual eye exam for those with diabetes for diabetic retinopathy. Medicare also coverscataract surgery.

Other coverage options for eyeglasses

There are several organizations that can help with the costs of your eyeglasses and vision care. Some examples include:

• EyeCare America. This is a service from the American Academy of Ophthalmology that partners with area volunteer eye doctors to provide eye exams. However, this organization doesn’t provide eyeglasses.
• Lenscrafters Foundation: OneSight. This foundation has provided more than 10 million eyeglasses to those in need since its founding.
• Lion’s Club International. This nonprofit organization provides free eyeglasses to those in its member communities. Contact your local Lions Club chapter to find out more.
• Medicaid. Medicaid is a state-based government program that helps pay for healthcare and other services for those in need. While Medicaid coverage may vary state by state, many programs pay for a pair of eyeglasses and lenses once every 5 years.
• New Eyes for the Needy. This is another nonprofit program that helps provide eyeglasses for those in need. Visit its website to see if you may qualify.

The takeaway

Medicare does not offer comprehensive vision coverage, including paying for eyeglasses. It usually covers medical services related to vision, such as testing for diabetic retinopathy or glaucoma.

If you or a loved one could use help purchasing eyeglasses, there are several community and national organizations dedicated to helping provide vision care.