Does Medicare Cover Prescription Eyeglasses?
Uncover Medicare's rules for prescription eyeglasses. Learn what vision care is covered, what isn't, and explore alternative coverage options.
Medicare is the United States’ federal health insurance program, primarily serving individuals aged 65 or older, younger people with certain disabilities, and those with End-Stage Renal Disease. A common question for beneficiaries is whether Medicare covers routine services like prescription eyeglasses. This article clarifies Medicare’s coverage for eyeglasses, outlining standard provisions and alternative options.
Original Medicare and Eyeglasses
Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), generally does not cover routine eye exams or prescription eyeglasses.
However, Medicare Part B does provide coverage for one pair of eyeglasses or contact lenses after cataract surgery that implants an intraocular lens. This coverage is medically necessary because the surgery often changes a person’s vision prescription. The benefit typically includes standard frames and basic lenses, and the eyewear must be obtained from a Medicare-enrolled supplier. Beneficiaries are responsible for the Part B deductible and 20% of the Medicare-approved amount for these corrective lenses.
Medicare Advantage Plans and Eyeglasses
Medicare Advantage plans, also known as Part C, offer an alternative way to receive Medicare benefits. These plans are provided by private insurance companies approved by Medicare and must cover all the services that Original Medicare covers. A significant difference is that many Medicare Advantage plans often include additional benefits not covered by Original Medicare, which can frequently encompass routine vision care.
Many of these plans offer coverage for annual eye exams and contribute towards the cost of prescription eyeglasses or contact lenses. The specific benefits, including allowances for eyewear, network restrictions, and out-of-pocket costs, vary considerably from one plan to another and by geographic location. Individuals enrolled in a Medicare Advantage plan should review their specific plan details to understand their vision coverage and any associated limitations or copayments.
Other Ways to Cover Vision Costs
For individuals whose Medicare coverage does not include routine eyeglasses, several alternative options exist to help manage vision care expenses. One common approach is to purchase a standalone vision insurance plan. These private plans typically involve a monthly premium and can cover routine eye exams, prescription eyeglasses, and contact lenses, often with specific allowances or discounts.
Another option involves utilizing discount programs offered through various professional organizations or retail chains. These programs provide reduced prices on eye exams and eyewear rather than functioning as traditional insurance coverage. It is worth noting that Medicare Supplement Insurance (Medigap) policies generally do not cover routine vision care, as they are designed to help with out-of-pocket costs for services covered by Original Medicare.