Does Medicare Cover Vision Services?
I will be enrolling in Medicare in a few months and would like to know if Medicare covers vision services. I currently have vision insurance through my employer but it will be discontinued when I retire.
Many people approaching age 65 are unclear regarding what Medicare does and does not cover when it comes to vision services. The good news is that original Medicare covers most medical issues, like cataract surgery, treatment of eye diseases and medical emergencies. Unfortunately, routine care, including eye exams and eyeglasses, are the beneficiary's responsibility. Here is a breakdown of what is and is not covered.
Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But it does cover yearly medical eye exams if you have diabetes or a high risk of developing glaucoma. Medicare will also pay for exams to test and treat medical eye diseases or serious eye problems, like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye.
Eye surgeries: Medicare will cover most eye surgeries that help repair eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra charge for a specialized lens can cost up to $2,500 per eye.
Eye surgeries that are typically not covered by Medicare include refractive (LASIK) surgery, cosmetic eye surgery or other procedures that are not considered medically necessary.
Eyeglasses and contact lenses: Medicare does not cover eyeglasses or contact lenses. There is one exception. If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation.
Ways to Save
Although original Medicare's vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several options to consider.
Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans, which are sold through private insurance companies, will cover routine eye care and eyeglasses. These plans may also cover your hospital and medical insurance and prescription drugs. See Medicare.gov/find-a-plan to shop for plans.
Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the cost. These policies typically run between $12 and $20 per month.
Check veterans benefits: If you are a veteran and qualify for VA healthcare benefits, you may be able to get some or all of your routine vision care through the VA. Go to Vets.gov and search for "vision care" to learn more.
Shop around: Many retailers provide discounts – between 10% and 30% – on eye exams and eyeglasses if you belong to a membership group like AARP or AAA. Check out the vision centers at discount retailers or, if you have a copy of your prescription, consider buying your glasses online.
Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find these centers, try calling your local Lions Club for referrals.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.