Medicare and Eye Glasses: What to Know About Vision Benefits And Medicare

• Original Medicare does not include vision coverage as part of its benefits. 

• Many Medicare Advantage plans include additional benefits, including those for vision, dental, and hearing. Specific benefits will vary based on the MA plan chosen, however.

• Medigap policies will not help with vision care costs, including those for vision insurance premiums, eyeglasses, contact lenses, and routine eye exams.

• Some non-profits can help Medicare beneficiaries obtain eyeglasses and receive low-cost vision care.

Eye health is an important part of health care. Sometimes, this means eyeglasses or contact lenses as well as routine vision exams. But does Medicare include vision coverage? 

In short, Original Medicare coverage does not include vision as part of its benefits. This includes coverage for corrective lenses such as contacts or eyeglasses. Medicare also does not cover routine eye exams. 

Medicare Advantage plans, however, may include vision as part of its extra benefits. In addition, there are non-profits and other means of getting coverage for vision needs. Medicare beneficiaries can also enroll in private insurance plans for vision care.

So, does Medicare cover glasses? This resource will explain everything Medicare beneficiaries need to know about Medicare and eyeglasses, including vision coverage, paying for corrective lenses, and more.

As a reminder, Original Medicare only consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). These Medicare Parts do not include vision coverage. This means Medicare will not cover eye exams and other routine vision care services. This means beneficiaries should expect to pay 100% of out-of-pocket costs for any vision-related care and products.

However, Medicare will cover corrective lenses following the implant of an intraocular lens if you get cataract surgery.

Medicare covers cataract surgery if it is deemed to be medically necessary treatment. If that is the case, Medicare Part B (medical insurance) will cover 80% of costs, and Medicare patients are expected to cover the remaining 20%. The Medicare Part B deducible also applies.

When Does Medicare Cover Eyeglasses?

Medicare covers eyeglasses following cataract surgery. Medicare Part B will cover the costs of corrective lenses (either one pair of eyeglasses with standard frames or one set of contact lenses) after cataract surgery.

Medicare Costs for Eyeglasses and Contact Lenses After Cataract Surgery

Beneficiaries can expect to pay 20% of the Medicare-approved amount for corrective lenses after every cataract surgery. The Medicare Part B deductible applies. Additional costs may occur for upgraded frames. 

Finally, it is important to confirm that the eyeglasses or contact lenses suppliers are approved providers and enrolled in the federal Medicare program. If they aren’t, Medicare won’t help pay.

Medicare Advantage plans, also known as Medicare Part C or MA plans, are supplemental Medicare plans offered through private insurance companies that are approved by Medicare. A Medicare Advantage plan will bundle both Medicare Part A and Medicare Part B. Most Medicare Advantage plans also include additional health benefits for dental, vision, and hearing. Some MA plans may also include prescription drug coverage, known as Medicare Part D. 

Not every single MA plan will include all of the aforementioned additional benefits. Interested parties should always contact the insurance company to confirm additional coverage for extra health care benefits such as vision.

Tips for Choosing a Medicare Advantage Plan With Vision Benefits

While many Medicare Advantage plans do include extra coverage for needs such as vision care, not all do. That said, there are various ways to confirm coverage for vision.

Use Medicare’s MA plan comparison tool

This helps beneficiaries compare MA plans prior to enrolling. Compare plans here.

Speak with a licensed insurance agent

They are educated on everything their plans have to offer, helping beneficiaries make the most informed decisions.

Medigap or MedSupp plans are supplemental Medicare plans that intend to ​“fill in the gaps” of Original Medicare. Medigap plans often help with deductible, copayment, and coinsurance payments. 

When it comes to eye care, Medigap plans will not help Original Medicare beneficiaries with payments. As well, Medicare Advantage enrollees cannot be enrolled in both a Medicare Advantage plan and have a Medigap policy.

For Medicare beneficiaries not enrolled in a Medicare Advantage plan that contains vision care, there are other means to get help paying for eyeglasses and other vision services.

EyeCare America

EyeCare America is a public service program that offers vision care through volunteer eye doctors. Most vision services are provided completely free to the patient. 

Eyecare America offers two programs: 

• The Seniors Program: The Seniors Program helps eligible seniors age 65 and over find a local eye doctor who volunteers to provide eye exams.

• The Glaucoma Program: The Glaucoma Program provides glaucoma eye exams to those who are eligible with no vision insurance. Glaucoma is a serious eye disease and many who are high risk do not know they are.

It’s important to understand that EyeCare America does not provide coverage for eyeglasses or eyeglass prescriptions. 

Note: Learn more about EyeCare America’s programs and eligibility requirements at this resource.

New Eyes

New Eyes is a non-profit that purchases new prescription glasses for children and adults with financial limitations. Interested people can apply for eyeglasses through new Eyes here.

Note: Learn more about New Eyes at this resource.

Lions Club

Lions Club is a nonprofit organization that may provide eyeglasses for those in need. Interested individuals should contact their local Lions Club for information. 

Note: Learn more about Lions Club at this resource.

Which lenses does Medicare cover?

Medicare covers medically necessary cataract surgery that involves the implant of an intraocular lens along with corrective lenses required after the procedure. Medicare will not cover elective surgeries or any eyeglasses non associated with medically necessary surgery.