Medicare Benefits for Eyeglasses

As you age, you lose the ability to see close objects and small print. You also are subject to eye conditions like glaucoma (too much fluid pressure in the eye) and cataracts (cloudy vision). If you don't need eyeglasses or contacts before then, you almost certainly will by the time you start Medicare, which is age 65, unless you've qualified earlier due to a disability. Medicare provides limited vision coverage in specific situations, including eyeglasses.

Routine Eye Care

• Medicare does not cover preventative vision screenings. Medicare will cover some tests for specific conditions, like glaucoma, macular degeneration (an age-related disease the dulls central vision) and cataracts. Similarly, Medicare doesn't cover eyeglasses and contacts unless they are associated with a specific medical condition.

Cataract Surgery

• Medicare will cover eyeglasses or contacts after a cataract surgery. Medicare will cover standard frames, will cover the glasses even if you had glasses before, and will cover both lenses even if only one eye was operated on. Make sure that the eyeglass or contact provider is contracted with Medicare and accepts assignment, otherwise all or part of the costs will be your responsibility. In this case, the eyeglasses or contacts are covered under Part B of Medicare, and will be subject to your annual deductible, if it's not satisfied or covered elsewhere, and a 20 percent co-pay, if that's not covered by other insurance.

Medicare Advantage Plans

• An alternative source for Medicare eyeglass coverage is a Medicare Advantage plan. Medicare Advantage plans take the place of Medicare, although you still have all the rights associated with being a Medicare beneficiary. Medicare Advantage plans usually offer benefits not typically covered by Medicare, including vision coverage. Typically, an annual routine eye exam is covered, and glasses or contacts are covered every 24 months.

Medicaid

• If you are impoverished, you may qualify for Medicaid, which is full health coverage for very low-income seniors. Medicaid becomes secondary to Medicare. Medicaid is funded by states as well as the federal government, so coverage varies from state to state, but in general, treatment for eye diseases and any needed supplies, including eyeglasses, is covered. Some states also cover routine eye exams and screenings.