Does Medicare Cover Eyeglasses?

By Medicare Benefits - October 4, 2020

Healthy vision gives you the ability to take in a lot of information about your world, but as we age, eyesight can be one of the most affected senses. Eyeglasses are usually the first line of defense in correcting vision problems, but in some cases, surgery may be necessary. If you’re getting older and you’re finding that you’re having a harder time seeing clearly, you will likely need to talk to your doctor and possibly meet with an optometrist to discuss corrective lenses. You’ll also want to know about options for covering the cost of visiting an optometrist, or for  glasses, contact lenses, and other eye care.  

Original Medicare does not provide coverage for routine vision care or eyeglasses. This means that if you need regular corrective lenses that are not related to recovery after a surgical procedure, you will need to pay the full cost of your vision care and eyeglasses out of your own pocket.

Medicare coverage after vision surgery
You may have Medicare coverage for eyeglasses if they are deemed medically necessary after certain procedures, including eye surgery. In these cases, corrective lenses may be covered for a temporary period of time to help your eyes recover or to help you achieve normal vision while you heal. If Medicare does provide coverage in such a case, billing will be issued to Part B. This is the outpatient benefit and will cover the cost of things like durable medical equipment, visits to your physician, diagnostic testing and more.

Medication benefits and vision health
Medications that are prescribed after vision surgery may be covered by Medicare Part D as long as you carry this coverage and the medications are available for purchase from a retail pharmacy. Medications administered in a clinical setting may be covered by Part B. If you need to be issued temporary corrective lenses while admitted to a hospital or skilled nursing facility, Medicare Part A, the inpatient benefit, will likely cover the cost.

You also need to keep in mind that the selection of frames from which you can choose will likely be limited if Medicare provides coverage. In many cases, Medicare only covers one pair of traditional lenses and a traditional frame. This means that your preferred style may not be available, and if you require bifocals, you will likely only be able to receive lenses with the line visible.

Do Medicare Advantage plans cover eyeglasses?
Medicare Advantage (MA) plans can sometimes offer additional benefits to Medicare patients on top of the traditional benefits offered through the program. Some MA plans may give you coverage for eye exams and glasses, but others may offer discounts or reimbursement opportunities when you purchase your own glasses. Of course, MA plans have to carry the same coverage as Original Medicare, so any coverage that you would be entitled to under Original Medicare would also be available under an MA plan. To learn more, you will need to talk to your MA plan provider.

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