Besides dental, one of the most asked questions is Does Medicare Cover Vision? The first thing to remember is that vision care has a wide range. It could be something as simple as getting glasses for reading to getting cataract surgery performed.
Fortunately, Medicare provides coverage stronger coverage for vision care than dental benefits.
While there are some stipulations and exceptions, Medicare’s vision coverage is pretty good when it comes to issues that are part of the aging process.
Inside you will find out how Medicare covers vision, eye exams, glasses and cataract surgery.
What Original Medicare Doesn’t Cover
Original Medicare will not cover things such as:
- routine vision exams known as eye refractions
- glasses (unless prescribed after a cataract surgery)
- contact lenses.
In addition, if you do get corrective lenses after cataract surgery, Medicare will not cover any costs for upgraded frames.
What Original Medicare Does Cover
Original Medicare will cover such things as:
- Medically necessary treatment for eye problems including:
- Macular Degeneration
- Eye exams for diabetic retinopathy (if you have diabetes)
- Glaucoma tests if you have diabetes or classified as high risk
What Medicare Medicare Supplements Will Cover
Medicare Supplement plans are designed to help cover the costs left over after Medicare approves a charge and covers their portion. Since your Medicare approved vision services would be provided under Part B of Medicare, your supplement would typically cover the remaining 20% of approved charges. If you were on Medicare prior to January 1, 2020 then you might have a Plan F or Plan C that would also cover the Part B annual deductible. If you went on Medicare January 1, 2020 or after then Plan F and Plan C are not available to you so therefore you would have the Part B deductible to pay first before your plan would kick in.
While Medicare Supplements were not designed to cover routine vision exams or corrective lenses, some Medicare Supplement insurance carriers offer a discounted vision benefit as a value add. For more robust benefits you can purchase a private plan that could include not only vision benefits, but also dental and hearing.
Do Medicare Advantage Plans Cover Vision Benefits?
Just like original Medicare, a Medicare Advantage plan will cover the same type of medically necessary benefits.
In addition, Medicare Advantage plans typically do cover some of the routine services such as an eye exam and an allowance to use towards glasses.
Not all Medicare Advantage plans offer the same additional vision benefits. In addition, some require you to pay an additional amount to add benefits such as these and dental to their plans. Always be sure to check your plan’s benefit disclosure.
Hopefully, this article helped to give you a better sense of how vision benefits are handled with Original Medicare, Medicare Supplements, and Medicare Advantage plans.
Senior Benefit Services has been in the Medicare business for over 50 years and understands your concerns.
To make sure everything is understood correctly, give a Senior Benefit Services Expert a call today at (800)924-4727!