Medicare & Vision Care: What’s Covered?

brandonwashington10
Mar 12
3 min read

Good vision is essential for maintaining independence and quality of life, but many Medicare beneficiaries are surprised to learn that Original Medicare (Parts A & B) does not cover routine vision care. However, there are options available to help with vision-related expenses. Here’s what you need to know about Medicare & vision care and how to get the best coverage for your eye health.

Does Medicare Cover Routine Vision Care?

Original Medicare does not cover routine eye exams, eyeglasses, or contact lenses. However, Medicare does cover some vision-related services if they are medically necessary.

What’s NOT Covered?

❌ Routine eye exams for glasses or contacts❌ Eyeglasses or contact lenses (except in certain cases)❌ LASIK or other refractive eye surgeries for vision correction

What’s Covered?

✅ Medically Necessary Eye Exams – Exams related to eye diseases, such as glaucoma or macular degeneration✅ Cataract Surgery & Lenses – Surgery to remove cataracts and one pair of post-surgery glasses or contacts✅ Glaucoma Screenings – Covered for high-risk individuals (diabetes, family history, African American age 50+, Hispanic age 65+)✅ Diabetic Retinopathy Exams – Annual screenings for diabetic beneficiaries✅ Eye Injuries & Diseases – Treatment of eye conditions, such as infections, dry eye disease, or detached retinas

Medicare Part B Vision Benefits

Medicare Part B covers medically necessary eye care, including:

Cataract surgery using traditional or laser methods
Eye exams for diabetic retinopathy (once per year for diabetics)
Treatment for macular degeneration
Glaucoma tests once every 12 months for high-risk individuals

Costs with Part B:

You pay 20% of the Medicare-approved amount after meeting the Part B deductible ($240 in 2024).
If a hospital outpatient setting is used, additional hospital facility fees may apply.

Medicare Advantage (Part C) & Vision Coverage

Many Medicare Advantage (Part C) plans include additional vision benefits beyond what Original Medicare covers.

✅ Routine eye exams ✅ Eyeglasses & contact lenses ✅ Discounts on LASIK or other vision correction procedures

Because benefits vary by plan, check with your provider to understand the coverage available to you.

How to Get Additional Vision Coverage

If you need vision coverage beyond Medicare’s limited benefits, consider these options:

1. Medicare Advantage (Part C) Plans

Many plans include routine vision care, exams, and eyewear.
Compare plans based on network providers, coverage limits, and out-of-pocket costs.

2. Standalone Vision Insurance Plans

Private insurers offer vision plans with low-cost exams and glasses.
Ideal for beneficiaries who do not have Medicare Advantage.

3. Vision Discount Programs

Some organizations, such as AARP or AAA, offer vision discount programs.
Not insurance, but they provide reduced rates on eye exams and glasses.

4. Medicaid & Low-Income Assistance

If you qualify for Medicaid, some states provide additional vision benefits.
Extra Help programs may assist with vision-related expenses.

Tips for Saving on Vision Care with Medicare

💡 Use Medicare-covered services for medical eye conditions (glaucoma, cataracts, diabetic retinopathy).💡 Compare Medicare Advantage plans if you need routine eye care.💡 Check for state or nonprofit programs offering assistance for seniors’ vision care.💡 Use retailers offering senior discounts on eye exams and glasses.

Final Thoughts

While Original Medicare doesn’t cover routine vision care, you have options for reducing costs and maintaining healthy eyesight. Medicare Advantage plans, standalone vision insurance, and discount programs can help fill in the gaps.

Need help choosing a Medicare plan with vision benefits? Lindbergh and Associates is here to guide you!

📞 Call us today or schedule a free consultation to explore your Medicare vision care options!