Does Medicare Cover Vision? Understanding What’s Actually Included
Many people are surprised to learn that
Original Medicare does
not cover routine vision care — even though eye health is a key part of aging well.
If you wear glasses or contacts, or want regular eye exams, it’s important to understand what’s
covered under Medicare, and what requires
extra coverage through a Medicare Advantage plan.
Let’s clear it up.
What Medicare Does Cover for the Eyes
Original Medicare
Part B covers
medically necessary eye care, including:
1. Eye Conditions and Injuries
Medicare covers exams, testing, and treatment related to:
- Glaucoma
- Cataracts
- Macular degeneration
- Eye infections or injuries
- Diabetes-related eye disease (retinopathy)
These are
medical problems, not vision correction.
2. Glaucoma Screenings
- Covered once every 12 months if you’re at high risk (e.g., diabetes, family history, African American over 50 or Hispanic over 65)
3. Cataract Surgery
- Medicare pays for standard cataract surgery (including lens implants)
- Also covers one pair of glasses or contacts after cataract surgery
But ongoing eyewear or exams for nearsightedness or astigmatism are
not covered
What Medicare Does Not Cover
- Routine eye exams for vision correction (“refractions”)
- Glasses or contact lenses (except after cataract surgery)
- LASIK or other elective vision correction surgeries
- Contact lens fittings
If your vision is getting worse and you don’t have a specific medical diagnosis, Medicare
won’t pay for the exam or glasses.
What About Vision Coverage With Medicare Advantage?
Many Medicare Advantage (MAPD) plans include routine vision coverage, such as:
- Annual eye exams
- Eyeglass and contact lens allowances (typically $100–$300/year)
- Discounts on upgraded lenses or frames
- Some plans even offer retinal imaging or tele-optometry visits
These benefits are
not standardized and vary by plan — some cover much more than others.
What Are My Options if I Need Routine Vision Care?
- Enroll in a Medicare Advantage plan that includes vision
- Purchase a standalone vision plan
- Use discount programs or cash-pay options at retail vision centers
- Apply for community-based vision care assistance (if low-income)
FAQs: Medicare and Vision Coverage
1. Does Medicare cover eye exams?
Yes,
if it's for a medical issue, like glaucoma or diabetes.
No, if it's for routine vision correction.
2. Does Medicare pay for glasses?
Only
after cataract surgery, and only
one pair of standard frames/lenses.
3. Can I get vision coverage with a Medigap plan?
No —
Medigap (Medicare Supplement) plans do
not include vision, dental, or hearing benefits. You’ll need
separate coverage.
Let’s Help You See Clearly — Literally.
At
Peace & Grace Insurance Services, we help you:
- Find Medicare Advantage plans that include routine vision
- Compare allowances for glasses and contacts
- Understand exactly what’s covered by your current plan
Call/Text:
209-812-4026
Email:
CSinsurepng@icloud.com
Proudly serving all counties in California
