Does Medicare Cover Routine Eye Exams, Glasses, or Contacts?

If you’re one of the millions of individuals with a Medicare plan, you may have asked yourself if Medicare vision coverage is available. The answer? It depends on your health and the type of coverage you're looking for. Let’s cover four Medicare Part A to D frequently asked question.

1.       Does Medicare Part A cover any vision benefits?

Not unless it’s a medical problem/emergency. Medicare Part A is intended to serve individuals strictly as a hospital insurance. If you are admitted to the hospital because of an accident involving your eyes, your plan benefits would apply; otherwise, you are responsible for all costs associated with routine vision corrections and eye exams. Oftentimes, individuals with Medicare Part A enroll in a private, individual vision insurance plan for coverage.

2.       Which vision benefits are available with my Medicare Part B plan?

Medicare Part B is a medical insurance plan. As such, coverage applies to some vision care, but only when you have a medical condition that involves your eyes or affects your vision. Medicare Part B does not cover routine eye examinations and vision correction. That means prescription glasses and contact lenses will not be covered by your plan unless you have had a necessary cataract surgery.

Medicare Part B does cover annual glaucoma screenings for high-risk patients. These include individuals with diabetes or a family history of glaucoma, African Americans over the age of 50, and Hispanics over the age of 65. Medicare Part B also covers cataract surgery, prosthetic eyes, and special treatments for macular degeneration, but a 20% coinsurance cost typically applies to many of these treatments.

3.       Will my Medicare Part C plan provide routine vision benefits?

Not always. Medicare Part C plans are provided by private health insurers. Each plan must provide the same benefits as Medicare Part B, but they may also include additional benefits. Many Part C plans include routine vision benefits, but you should make sure this is the case ahead of time. Part C plans help individuals group everything into one plan, but you should expect to pay more per month for plans with vision coverage.

4.       Medicare Part D covers prescription drugs, right? What about medicines for my eyes?

Medicare Part D plans are provided by private insurers for prescription drug coverage not covered by other forms of Medicare. They’re used together with either Medicare Part A or Part B to reduce costs, especially to individuals who require many prescriptions. Part D will not cover routine vision exams or vision correction but will apply to things like eye drops and medications prescribed by your optometrist.

Regardless of which plan you have, be sure to read through your Medicare benefits thoroughly before heading off to your eye doctor. As you get older, routine eye exams are even more important to preserve your vision — and even your physical health. After all, eye exams can help detect signs of diabetes, high blood pressure, and high cholesterol.

If you don’t have Medicare vision coverage, find out how VSP Individual Vision Plans you can save on your next eye exam or pair of glasses. Find a vision insurance plan, customized just for you.

Your vision. Your way.

Not covered for vision? Get an individual plan, customized for you – including where you want to use it: at the doctor, in a retail location, or even online.

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