Most of us need corrective lenses to see clearly as we age and both eyeglasses and contact lenses can be expensive. Unfortunately, Medicare doesn’t cover the cost of glasses or contact lenses for most people. However, in one specific instance, they are covered. Read on to learn more.
Key Takeaways
- Eyeglasses are corrective eyewear used to make a person’s vision clearer.
- Contact lenses are an alternative form of corrective eyewear if eyeglasses are inconvenient.
- Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. will cover a single pair of eyeglasses as a part of Medicare-approved cataract surgery.
- Medicare Part B will cover 80 percent of the costs for Medicare-approved eyeglasses, but the frames must be a standard design.
- Most Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). have coverage for eyeglasses and routine vision care.
- MedigapMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. policies are available to help with the costs of corrective eyewear when Part B provides coverage for them.
The one situation in which Medicare does cover eyeglasses is after cataract surgery. If you need cataract surgery and your doctor implants an intraocular lens, Medicare covers 80 percent of the cost for one pair of eyeglasses or one set of contact lenses from a Medicare-approved supplier. Some Medicare Advantage plans cover eyeglasses or other corrective lenses as a part of routine eye exams.
What Are Eyeglasses?
Eyeglasses are corrective lenses made of either glass or more commonly plastic, which are worn over a person’s eyes with a frame to keep them in place. The lenses adjust how light refraction is perceived by a person’s eyes to produce a clearer image for the brain to understand. An estimated eleven million Americans need a pair of eyeglasses and/or other corrective services for vision disorders, such as: 1my.cleavelandclinic.org, “Eyeglasses“, Accessed November 3, 2021
- Nearsightedness (myopia)
- Farsightedness (hyperopia)
- Astigmatism
- Presbyopia
Contact Lenses
Contact lenses are corrective vision lenses similar to eyeglasses, but they are worn directly on the eye. Contact lenses are a useful eyewear alternative for people that cannot wear eyeglasses due to an active lifestyle. However, contact lenses have an increased risk for eye irritation or infection if they are applied or cleaned improperly.2health.cleavelandclinic.org, “Are Contact Lenses Right for You?“, Accessed November 3, 2021
How Does Medicare Cover Eyeglasses?
Generally, Medicare does not cover eyeglasses or other types of corrective lenses. However, Medicare does pay for corrective lenses if you have cataract surgery to implant an intraocular lens. In this case, Medicare covers one pair of eyeglasses with standard frames or one set of contact lenses. You pay 20 percent of the Medicare-approved amountA Medicare-approved amount is what Medicare will pay for a covered service. Healthcare providers that agree to Medicare assignment accept the approved amount without excess charges. What Does Medicare-Approved Amount Mean? A Medicare-approved amount is....3Medicare.gov, “Eyeglasses & contact lenses“, Accessed October 29, 2021
How Much Do Eyeglasses Cost?
The cost for eyeglasses can vary by area and by brand, with standard frames ranging from $8 to over $600 per pair, averaging about $195 per pair. If you want luxury frame prescription eyeglasses like Ray-Bans or Oakley, the cost can easily reach over $1,000.
If a pair of standard frame eyeglasses are part of a Medicare-approved treatment, Medicare Part B will cover 80 percent of the approved cost once the beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. has paid their annual Part B deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share..4visioncenter.org, “How Much Do Glasses Cost?“, Accessed November 12, 2021
Medicare Advantage
Medicare Advantage plans are required to cover the same benefits as Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B. However, they can include additional benefits not offered by Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.. A growing number of Medicare Advantage plans include eyeglasses and routine vision care as part of their benefits package.5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 12, 2021
Some plans limit how many eyeglasses they cover per year and some do not cover eye care services at all. Each plan varies when it comes to its expanded benefits, so you will have to compare Medicare Advantage plans in your area about what expanded services they cover.
Summary
Unless you need surgical treatment for cataracts, Medicare will not provide coverage for eyeglasses or other corrective lenses to improve your vision. If you do get covered for eyeglasses because you had cataract surgery, Medicare will not cover additional pairs of eyeglasses if they are damaged or lost.
However, many Medicare Advantage plans do cover eyeglasses as part of their expanded vision services. If you want Medicare to cover eyeglasses, routine eye exams, and other vision benefits, compare the costs and benefits of your area’s Medicare Advantage plans to Orginal Medicare coverage.
Citations
- 1my.cleavelandclinic.org, “Eyeglasses“, Accessed November 3, 2021
- 2health.cleavelandclinic.org, “Are Contact Lenses Right for You?“, Accessed November 3, 2021
- 3Medicare.gov, “Eyeglasses & contact lenses“, Accessed October 29, 2021
- 4visioncenter.org, “How Much Do Glasses Cost?“, Accessed November 12, 2021
- 5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 12, 2021