Available Mon-Fri, 9am-6pm ET  |  Call 800-970-1964

How Does Medicare Coverage Work With Eyeglasses and Contacts

How Does Medicare Cover Eyeglasses and Contacts?

As we age, it is important to stay on top of our eye care, especially if you are amongst the 90% of Medicare beneficiaries who need corrective lenses for either distance or near vision correction. 

The average glasses cost $242, and that is only the frames! Then you have to add the frames, the regular eye exams, and more, and the cost can quickly add up. So it is natural to wonder: Does Medicare cover eyeglasses and contacts? If that coverage isn’t enough (it usually isn’t), what else can you do?

Does Medicare cover eyeglasses and contacts?

For the most part, Original Medicare doesn’t usually cover eyeglasses or contact lenses.

What if you have cataracts or a serious vision problem?

Medicare will cover the cost of cataract surgery, provided it’s done using traditional surgical techniques or lasers.

Medicare Part B will also help pay for corrective lenses (meaning one pair of eyeglasses with standard frames or one set of contact lenses) if you have cataract surgery that implants an intraocular lens. After you meet the Part B deductible ($226 in 2023), Medicare pays 80%, and you pay 20% of Medicare’s approved amount for corrective lenses following each cataract surgery. Medicare will only pay for eyeglasses or contact lenses from a Medicare-enrolled supplier.

Generally speaking, Medicare does not cover eye exams. However, it will cover an eye exam if it is believed that you have a serious vision problem. That coverage is also under Medicare Part B. After you meet the Part B deductible, Medicare pays 80%, and you pay 20% of the approved amount for each eye exam, regardless of whether or not you have a serious vision problem.

Will Medicare cover cosmetic vision correction, such as Lasik surgery?

Medicare Cover Eyeglasses and Contacts

No, Medicare does not cover any cosmetic vision correction. You would have to pay 100% of the cost of this kind of procedure.

What does Medicare cover if I have diabetes?

If you have diabetes, Medicare Part B will cover the cost of a routine eye exam performed by a state-authorized ophthalmologist or optometrist once a year.

What does Medicare cover if I am at high-risk for glaucoma?

The following groups are considered high-risk for glaucoma:

  • African Americans aged 50 and older
  • Hispanics/Latinos aged 65 and older,
  • people with a family history of glaucoma, and
  • people who have diabetes.

If you are in any of these categories, Medicare Part B will cover a comprehensive eye exam every 12 months to detect glaucoma.

Supplemental Coverage Options for Eye Care

Explore your options

If you do not have an underlying condition but do need eye care, such as vision correction, you may be able to get coverage from a Medicare Advantage plan. These plans can help cover the cost of routine eye exams and may also provide a discount on eyeglasses or contacts.

Last year, 99% of Medicare Advantage plan members had some vision benefits, although most of those plans were capped at roughly $160. This plan only covers up to $160 for vision care expenses, meaning you would be left with the balance. Most of these plans covered an eye test once every 12 months. 

In 2022, the average out-of-pocket spending for vision was $194 for people in Medicare Advantage and $242 for traditional Medicare. Therefore, that $160 cap may not cover your vision needs. Therefore, some people choose to get a stand-alone policy that will bundle vision and dental coverage.

Below are a couple of our favorite stand-alone plans:

Manhattan Life – Dental, Vision, Hearing

Manhattan Life bundles dental, vision, and hearing together. It is affordable, ranging from $30 to $55/month, and you can use any prover.

Ameritas PrimeStar Dental

Ameritas offers three versions of its PrimeStar dental plans: PrimeStar Value, PrimeStar Access, and PrimeStar Total, and you can add a vision rider to each plan for additional coverage.

It’s essential to make sure you select the right plan. Consider your expected costs. For example, if you expect to need more expensive eyeglasses or contact lenses, a stand-alone policy that includes vision coverage may be the better option. 

If your glasses prescription is reasonably weak, you may be able to save money by buying your eyeglasses at online stores like Warby Parker, EyeBuyDirect, or Zenni Optical or big box stores like Costco or Target.

Additional Options for Vision Care

You may have other options for vision care besides Medicare coverage. If you belong to a union or work for a large employer, you may be eligible for an employee-sponsored vision plan.

Additionally, there are many national retailers who offer their own discount programs, like EyeMasters and JCPenney Optical. And don’t forget about your local optometrist or ophthalmologist – many of them have their own special discounts and deals.

The National Eye Institute lists many different ways to save money on eye care, including free clinics and charities.

It is essential to research your options to make sure you get the best coverage and savings for your vision care needs. It will take some time, but it can be well worth the effort if it helps you save on costly eye care treatments.

Selecting the Right Vision Care Coverage

Your eyes and your sight are so important. We create memories through our vision, such as seeing a beloved grandchild for the first time. From beautiful sunrises to starry nights, our eyesight allows us to enjoy the world’s beauty. You must make it a priority to keep your eyes healthy and make sure they are properly cared for throughout retirement.

That’s why you need adequate coverage for any eye care expense that may come up when you are retired.
Making sure you have the right coverage can be overwhelming, and that is where The Medicare Family comes in. Schedule an appointment, and we will help you see (pun intended) the possibilities and empower you to make the best choices for you and your family.

Medicare Mama Pink

ABOUT THE AUTHOR

Sylvia Gordon

Sylvia Gordon, also known as Medicare Mama, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family as well as a member of the Forbes Finance Council. Sylvia has served on the advisory boards of major insurance companies like United Healthcare, Cigna, Anthem, Globe Life, and Aetna Senior Supplemental Benefits. 

In her free time, she can be found answering questions on TikTok Live, taking care of her many animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.

Get Medicare Help Now