Vision Insurance

Does Medicare cover vision needs?

The answer is both yes and no. The extent of your Medicare vision coverage depends on the specific service or treatment you need. Generally, Original Medicare (Part A and Part B) does not cover routine vision care such as annual eye exams, eyeglasses, or contact lenses. However, certain vision services are covered under Medicare in specific circumstances.

Below is a breakdown of what Original Medicare includes:

Services covered by Medicare Part A and Part B

Medicare Part A

Part A provides vision-related coverage in situations requiring inpatient hospitalization. For instance, if a vision condition or treatment necessitates a hospital stay, Part A would cover those related costs.

Medicare Part B

Medicare Part B generally covers outpatient services and medical supplies, including limited vision-related care. Here is what’s included (but not fully covered):

Eye Exams for Diabetic Patients

Annual coverage for screening diabetic retinopathy.

Glaucoma Tests

Annual coverage for individuals at high risk. High-risk categories include:

Diagnosed diabetes
Family history of glaucoma
African Americans aged 50 or older
Hispanics aged 65 or older

Macular Degeneration Tests and Treatments

Covers diagnosis and treatment, including certain injectable drugs, for age-related macular degeneration.

Corrective Lenses Post-Cataract Surgery

Covers one pair of eyeglasses or contact lenses after cataract surgery involving the implantation of intraocular lenses.

What expenses does Medicare Part B cover?

For these services, Medicare Part B covers 80% of the Medicare-approved cost. You will pay the remaining 20%, along with any applicable deductibles. For treatments in outpatient settings, a copayment may also apply.

Alternative ways to pay for vision care with Medicare

If you're a Medicare recipient seeking more comprehensive vision coverage, consider these options:

1. Supplemental Vision Insurance

A standalone or supplemental vision plan can help cover routine care, such as annual eye exams, prescription glasses, contact lenses, or vision correction surgeries. This option is ideal for those with Medicare Part B and relatively healthy eyes.

At FTJ Senior insurance, we can guide you in deciding whether a supplemental vision insurance plan may work best for you.

2. Medicare Advantage Plans (Part C)

Medicare Advantage plans, offered by private companies, are an alternative to Original Medicare. These plans often include additional benefits, such as vision and dental coverage, that aren't included in Original Medicare.

Keep in mind that availability and benefits vary by state, so it’s important to look into the plans offered in your area. Medicare Advantage plans may provide coverage for services like routine eye exams, eyeglasses, and contacts.

Choosing the right option for you

Navigating Medicare vision coverage can feel overwhelming, but you have options. Whether you decide to explore upgrading to a Medicare Advantage plan or adding a standalone vision insurance policy, you can find a solution tailored to your needs.

Need help finding the perfect fit? Our licensed insurance agents at FTJ Senior Insurance are here to provide expert advice. Contact us below to discuss your options and find the best plan to suit your vision care needs.

Get free, personalized plan comparisons from top national carriers, so you can make the right choice.

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