Are vision exams covered under Medicare?

Have you had a hard time reading the grocery list lately? Does your phone screen look a little blurry when you send a text message? It might be time for a vision exam and some new glasses.

Vision changes are a normal part of aging and certainly an important part of your health. But after you retire, what’s the best way to pay for vision exams and glasses? Unfortunately, Medicare may not be the answer.

Let’s walk through the essential details you should know about Medicare and vision coverage.

What Does Medicare Cover?

Original Medicare (Part A and B) doesn’t cover routine eye exams. It also doesn’t cover costs for eyeglasses or contacts.

There are a few exceptions, however. Medicare Part B (medical insurance) will cover a simple vision test when you first sign up. This test is offered only once, and you must have the test within the first year you’re enrolled.

Part B will also cover some medically necessary vision tests and treatments for chronic eye conditions. It will cover:

  • Cataract surgery.
  • One set of corrective lenses after cataract surgery.
  • Eye prosthesis if you have a missing eye or eye shrinkage caused by surgery, trauma, or a birth defect (congenital disability).
  • Photodynamic therapy if you have macular degeneration.
  • Some diagnostic tests and screenings for glaucoma and macular degeneration.
  • Yearly eye exams if you have diabetes or diabetic retinopathy.

It’s important to remember that you will still have to pay coinsurance for these services — 20% of the amount approved by Medicare. The Part B deductible will also apply to these services, and you may need to pay a copay for some tests.

Before undergoing any vision test or procedure, it’s always a good idea to work with your doctor or healthcare facility to estimate costs. Prices can vary depending on the type of facility where you have the test or procedure.

How Do I Get Coverage for Vision Exams?

If you don’t want to pay out-of-pocket for all your vision exams, glasses, or contacts, you may consider enrolling in a Medicare Advantage Plan. Some of these plans will cover routine eye exams and glasses, but it’s essential to check each plan carefully to verify coverage.

Medicare Advantage plans are offered through private insurance companies. They include the same coverage as Original Medicare, plus extra services like dental, vision, and hearing.

Like Medicare Part B, Medicare Advantage may also have deductibles, premiums, and copays. That’s why it’s important to review all the coverage details before deciding on a plan.

Next Steps

If you still have questions about Medicare, we’re ready to help. Please call us at 305.541.5366 to schedule an appointment or learn more about the Medicare plans offered through LEON Health.

Ready to Enroll with LEON Health?

As you prepare for Medicare, you’ll be faced with many important decisions. LEON Health wants to help you select the best options for your needs.

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