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Does Medicare Cover Glasses?

December 14, 2023

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When exploring Medicare coverage for glasses, understanding the specifics is crucial for you as you seek vision-related benefits. While Medicare typically does not cover routine eye exams or eyeglasses, there are exceptions.

This overview will guide you through the instances of Medicare coverage for glasses, offering insights into the circumstances under which coverage may be available. It emphasizes the importance of exploring Medicare Advantage Plans for more comprehensive vision care.

Medicare coverage for glasses

Medicare generally does not cover the cost of your glasses, contact lenses, or routine eye exams for prescription purposes. However, there are specific situations where Medicare may provide you with coverage, such as following cataract surgery or for certain medical conditions. 

It's essential to check with Medicare or your healthcare provider to understand the specific circumstances under which coverage might be available.

Medicare Part A & B 

Medicare Part A and Part B typically do not cover the cost of eyeglasses or routine eye exams for the purpose of obtaining eyeglass prescriptions. 

However, there may be exceptions for specific situations, such as post-cataract surgery, where Medicare Part B may cover a portion of the cost for one pair of eyeglasses with standard frames.

Medicare Part D

Medicare Part D, which is optional prescription drug coverage, generally does not cover the cost of eyeglasses or vision-related expenses such as eye exams. Its primary focus is on providing coverage for prescription medications.

If you are seeking coverage for glasses, you may need to explore other avenues or consider Medicare Advantage plans (Part C), which may offer additional vision benefits, including coverage for eyeglasses and related services. 

Be sure to carefully review the details of your specific Medicare plan and its coverage options for a comprehensive understanding.

Medicare Advantage (Part C)

You may find that your Medicare Advantage Plan (Part C) offers coverage for glasses and various vision-related services not covered by Original Medicare (Part A and Part B). Your plan's additional benefits might encompass eye exams, eyeglasses, contact lenses, and other vision-related expenses. 

Be sure to review your policy documents or contact your health plan to understand the full extent of your vision coverage through your Medicare Advantage plan, if it offers this type of coverage.

Additional coverage options for eyeglasses  

Yes, you have several coverage options for glasses:

  • Vision Insurance: Consider purchasing vision insurance, which may cover the costs of eye exams, frames, lenses, and contact lenses. It's available as standalone coverage or as part of a comprehensive health insurance plan.
  • Supplemental Vision Insurance: Supplemental vision insurance plans can be purchased in addition to standard health insurance. These plans often cover a range of vision-related expenses, providing additional benefits beyond what health insurance may offer.
  • MedicaidMedicaid may cover eye exams and necessary corrective lenses, depending on your state's policies. Eligibility and coverage specifics differ by location.
  • Out-of-Pocket Options: Explore affordable out-of-pocket options, such as discounted programs, online retailers, and community health clinics that offer budget-friendly eyeglasses and eye exams.
  • Corporate Benefits: Check if your employer provides vision benefits as part of your employee benefits package. Many companies offer vision insurance or discounts on eye care services.
  • Online Retailers: Some online retailers offer cost-effective prescription glasses, allowing you to choose from a variety of frames and lenses at competitive prices.
  • Discount Programs: Consider joining optical discount programs that provide reduced rates on eye exams, eyeglasses, and contact lenses for a membership fee.

Before choosing an option, carefully review the coverage details, costs, and limitations to ensure it aligns with your specific needs.

How much are eyeglasses without insurance?

If you don't have health insurance with vision coverage, the cost of glasses can vary widely. On average, you should anticipate spending between $50 and $1,000 for a pair. The final expense hinges on factors like the type of lenses, frames, and any additional features you choose. 

For single-vision lenses without insurance coverage, you'll typically see a cost around $114, but if you opt for bifocal lenses, the price may increase. Keep in mind that brand-name frames and specialized features can contribute to higher costs. On average, the total expense for frames and lenses, without insurance, is around $350, offering potential savings of up to $200 on a complete set.

Note: These figures are general estimates, and the actual costs you incur may vary based on your individual preferences and needs.

How can I save money on coverage for glasses?

Consider the following tips to save money on eyeglasses:

  • Compare Vision Insurance Plans: Explore different vision insurance plans to find one that suits your needs and offers cost-effective coverage. 
  • Evaluate Employer Benefits: Check if your employer offers vision insurance as part of your benefits package. Employer-sponsored plans often provide cost savings.
  • Use Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs): Contribute to HSAs or FSAs to set aside pre-tax dollars for eligible medical expenses, including vision care and eyewear.
  • Seek Discounts: Some vision insurance plans and providers offer discounts on eyeglasses, contact lenses, and eye exams. Research available discounts through your insurance or vision care provider.
  • Consider Standalone Vision Plans: If you don't have employer-sponsored vision insurance, consider standalone vision plans that cater specifically to eye care needs.
  • Explore Discount Programs: Certain membership programs or discount cards may provide reduced costs for vision services and eyewear. Compare options to find the most beneficial program for your needs.
  • Opt for Generic Brands: When choosing eyeglass frames and lenses, opt for generic or more affordable brands to reduce costs.

Remember to assess your individual needs and preferences when selecting a vision insurance plan or alternative cost-saving strategies.

Contact us to Learn More About Medicare Advantage Plans

Ensuring you have the eyewear you need is a vital aspect of maximizing your Medicare Advantage benefits, if your plan does offer vision coverage. If you'd like to see if there's a Medicare Advantage plan with vision benefits in your area, call 1-800-596-1715 (TTY 711) weekdays from 8 a.m. to 8 p.m. EST. Our licensed insurance agents are professionally trained to help you understand your Medicare benefits or confirm if there is a Medicare Advantage plan in your area that meets your needs.

Outside of the Medicare Annual Enrollment Period, members can enroll in a plan only if they meet certain criteria. 
 

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