If you’re enrolled in Medicare, routine vision care isn’t guaranteed.
Some privately administered Medicare Advantage plans cover eyeglasses and eye exams.
But Original Medicare — which provides health insurance to about 37.7 million Americans — doesn’t pay for your new eyeglass frames or an annual vision exam.
So how do you know, in your own case, what’s covered and what’s not?
Whether you’re new to Medicare and wondering what to expect at your next eye exam, or you’re a long-time beneficiary trying to save money on glasses, our guide to Medicare vision coverage and affordable eye care is here to help.
How Medicare Covers Vision
If you have a serious eye disease like cataracts or glaucoma, Medicare Part B will generally pay for treatment.
But that’s not the case for routine exams and eyeglasses.
Most private Medicare Advantage plans provide some coverage for glasses and routine vision tests. Original Medicare does not.
Here’s how it breaks down.
Original Medicare does not cover routine vision exams, eyeglasses or contact lenses. Lasik surgery isn’t covered either.
You’re on the hook for the full cost unless you have a separate private vision care policy or secondary insurance like Medicaid.
Original Medicare does cover eye care related to illness or injury, including cataract surgery and glaucoma screenings. More on that shortly.
Nearly all Medicare Advantage plans — which are administered by private insurance companies like United Healthcare and Cigna — include some routine vision coverage.
However, vision benefits are pretty modest — plans offer about $160 worth of eyewear and eye exam coverage a year on average, according to an analysis by the Kaiser Family Foundation (KFF).
Medicare Advantage plans also restrict the vision benefits they offer, including:
- how often you can replace glasses and/or contact lenses.
- how often the plan will pay for eye exams.
For example, 47%…