Does Medicare cover glasses and contact lenses?

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    original Medicare generally does not pay for glasses or contact lenses. You can get visual aid insurance through Medicare benefit or a private or group plan, but you should evaluate the value of such coverage before signing up.

    What you pay for glasses and contact lenses

    In most cases as a Medicare Part B Beneficiaries pay 100% of the cost of contact lenses and glasses, including frames and lenses.

    There is one exception: if you are going to have cataract surgery, Medicare Part B covers a set of corrective lenses if you need them after your intraocular lens has been implanted. The Part B Deductible, $ 203 in 2021, will apply and you will owe a 20% deductible of the Medicare-approved vision correction amount. You must purchase from a Medicare registered supplier.

    Alternative # 1: Medicare Advantage Privacy Screen

    If you want to have eyesight coverage, you should check out the Medicare Advantage plans available locally.

    The good news is that, according to the Kaiser Family Foundation, 99% of Medicare Advantage members can find a plan with some vision coverage. The bad news is that the average annual dollar limit for this cover is $ 160, far less than the average price of $ 366 for a pair of single vision glasses.

    The bottom line is that the average Medicare Advantage beneficiary paid $ 194 out of pocket for vision in 2018, which KFF says is only $ 48 less than the typical Medicare beneficiary spent. Given this relatively small difference in cost of ownership, it may not make sense to sign up for Medicare Advantage if eyesight care is the only benefit you need beyond what Original Medicare offers.

    Alternative # 2: An individual or group vision plan

    In the case of individual or group insurance, similar questions arise about value for the consumer. Vision plans that you buy yourself or through your employer or your spouse’s employer typically require a monthly premium of around $ 15 or $ 20, and they often have a number of restrictions.

    Here are some possible restrictions on private eyesight insurance:

    • There is probably a dollar limit on frames.

    • The plan may not pay for extras like lightweight or anti-glare glasses.

    • You may not be insured for both glasses and contact lenses in the same year.

    • There may be a waiting time of up to 30 days or longer when registering.

    Are the limited benefits of a private visual aid worthwhile? Take a good look before you sign up.

    When you still can’t afford glasses

    People who cannot pay for corrective lenses out of their own pocket can apply to the non-profit organization New eyes for a free basic pair of glasses. Your application requires the support of a social welfare office or another lawyer.

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