Medicare Doesn’t Cover That (Routine Vision)

Our “Medicare Doesn’t Cover That” series continues this week with routine vision care.  Along with dental coverage, vision is always a concern when we meet with Medicare beneficiaries.  So does Medicare cover vision services? The answer is…it depends.

Routine Eye Services

If your vision need is blanketed under 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.  

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.

Contact us for more information on your specific vision needs. We’ll help you determine if Medicare does (or doesn’t) cover it. 


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.