Does Medicare Pay for Eyeglasses?
Get clarity on Medicare's coverage for eyeglasses. Understand what vision benefits are included and find solutions for your eye care.
Medicare is a federal health insurance program for individuals aged 65 or older, younger people with certain disabilities, and people with End-Stage Renal Disease. Beneficiaries often ask if this program covers eyeglasses and routine vision care. To understand Medicare’s vision coverage, its different parts and available options must be considered.
Original Medicare Coverage for Vision
Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), does not cover routine eye exams, eyeglasses, or contact lenses; these costs are typically out-of-pocket. Medicare Part B does cover medically necessary eye care services, including diagnostic tests and treatments for eye diseases like glaucoma, cataracts, or diabetic retinopathy.
Routine vision care is excluded, but there is an exception for eyeglasses following cataract surgery. After cataract surgery to implant an intraocular lens, Medicare Part B covers one pair of eyeglasses or one set of contact lenses. This coverage applies only to the initial pair or set of lenses following the surgery; subsequent pairs or replacements are not covered by Original Medicare.
Medicare Advantage Plan Vision Benefits
Medicare Advantage Plans (Part C) are offered by private companies approved by Medicare. They must provide at least the same coverage as Original Medicare Part A and Part B. Many Medicare Advantage plans offer additional benefits that Original Medicare does not, including routine vision care such as eye exams, eyeglasses, and sometimes contact lenses.
The specific vision benefits, including allowances for frames and lenses, vary significantly from one Medicare Advantage plan to another. For example, a plan might offer an annual allowance of $150 to $200 for eyeglasses or contacts. Beneficiaries must review the Summary of Benefits for any specific plan to understand its exact coverage details, including any deductibles, copayments, or network restrictions.
Alternative Options for Eyeglass Coverage
For those with Original Medicare or a Medicare Advantage plan that doesn’t cover all vision needs, several alternative options exist for eyeglasses or cost assistance. One option is purchasing a stand-alone vision insurance plan. These plans typically cover routine eye exams and provide an allowance for frames and lenses, often with a small annual premium.
Discount vision programs offer reduced prices on eye exams and eyewear through participating providers. Many community health centers and Federally Qualified Health Centers (FQHCs) also offer vision services on a sliding fee scale based on income. Some charitable organizations or state-specific assistance programs may also provide aid for vision care and eyeglasses. Retail optical chains sometimes offer package deals or loyalty programs that can reduce the overall cost of new glasses.