Our “Medicare Doesn’t Cover That” series continues this week with routine vision care. Along with dental coverage, vision is always a concern for Medicare beneficiaries. So does Medicare cover vision services? The answer is…it depends.
Routine Eye Services
If you need routine care such as eye exams, Medicare doesn’t cover it (i.e. eye refraction). The same goes for eyeglasses. If you’re ready for a new pair of glasses or contact lenses, Medicare will not pay for it…unless it’s immediately following a cataract surgery.
NOTE: Some Medicare Advantage (Part C) plans include routine vision care, like eye exams and eyewear allowances.
Medical Eye Services
Now, if you have medical issues with your eyes, your vision services will go through your Medicare Part B (medical/outpatient) benefits like any other Medicare-approved medical service. This includes, but is not limited to:
Cataracts – One pair of glasses with standard frames or one set of contact lenses are covered only after a cataract surgery.
Glaucoma – Glaucoma tests are covered once every 12 months if you’re at high risk due to diabetes, family history, etc.
Macular Degeneration – Certain tests and treatments can be covered by Medicare if you have age-related macular degeneration.
Diabetic Eye Exams – If you have diabetes, these exams are covered once every 12 months.
And remember, “covered” doesn’t mean it’s fully paid for. It simply means Medicare approves the service. Depending on your insurance coverage, you may have additional out-of-pocket costs for these services in the form of a copay or deductible payment.
Reference Links
www.medicare.gov
Eye exams (routine)
Eyeglasses & Contact Lenses After Cataract Surgery
Glaucoma Tests
Macular Degeneration Tests
Diabetic Eye Exams
Neither Medicare Mindset LLC nor its agents are connected with the Federal Medicare program.
