Does Medicare Cover Eye Exams, Glasses, or Contacts?

Category: Vision Insurance
Richard Lee and Jessica Caswell, 09/07/2023 12:00 am

If you’re one of the millions of individuals with a Medicare plan, you may have asked yourself if Medicare vision coverage is available. The answer depends on your health and the type of vision coverage you're looking for. Here are answers to four Medicare Part A to D frequently asked questions.

1. Does Medicare Part A cover any vision benefits?

Medicare Part A does not include vision benefits, unless it’s a medical problem/emergency. Medicare Part A is intended to serve individuals strictly as a hospital insurance. If you are admitted to the hospital because of an accident involving your eyes, your plan benefits would apply; otherwise, you are responsible for all costs associated with routine vision corrections and eye exams. Oftentimes, individuals with Medicare Part A enroll in a private, individual vision insurance plan for vision coverage.

2. Which vision benefits are available with a Medicare Part B plan?

Medicare Part B is a medical insurance plan. As such, coverage applies to some vision care, but only when you have a medical condition that involves your eyes or affects your vision. Medicare Part B does not cover routine eye examinations and vision correction. That means prescription glasses and contact lenses will not be covered by your Medicare plan unless you have had a necessary cataract surgery. Medicare Part B does cover annual glaucoma screenings for high-risk patients. These include individuals with diabetes or a family history of glaucoma, African Americans over the age of 50, and Hispanics over the age of 65. Medicare Part B also covers cataract surgery, prosthetic eyes, and special treatments for macular degeneration, but a 20% coinsurance cost typically applies to many of these treatments.

3. Does Medicare Part C plan provide routine vision benefits?

Your Medicare Part C plan will not always include routine vision benefits. Medicare Part C plans are provided by private health insurers. Each plan must provide the same benefits as Medicare Part B, but they may also include additional benefits. Many Part C plans include routine vision benefits, but you should make sure this is the case ahead of time. Part C Medicare plans help individuals group everything into one plan, but you should expect to pay more per month for plans with vision coverage.

4. Does Medicare Part D cover medicines for my eyes?

Medicare Part D plans are provided by private insurers for prescription drug coverage not covered by other forms of Medicare. They’re used together with either Medicare Part A or Part B to reduce costs, especially to individuals who require many prescriptions. Part D will not cover routine vision exams or vision correction but will apply to things like eye drops and medications prescribed by your optometrist.

Regardless of which Medicare plan you have, be sure to read through your Medicare plan benefits thoroughly before heading off to your eye doctor. As you get older, routine eye exams are even more important to preserve your vision — and even your physical health. After all, eye exams can help detect signs of diabetes, high blood pressure, and high cholesterol.

If you don’t have Medicare vision coverage, find out how VSP Individual Vision Plans you can save on your next eye exam or pair of glasses. Find a vision insurance plan, customized just for you.

*Check your Medicare Plan to see if your vision care needs are covered. And/or if a VSP Individual Vision Plan is right for you. VSP Vision Care does not coordinate benefits with Medicare.

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Not covered for vision? Get an individual plan, customized for you – including where you want to use it: at the doctor, in a retail location, or even online.

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