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Does Medicare Cover Vision?

Christian Worstell by Christian Worstell    |    Published Nov 04, 2019    |    Reviewed by John Krahnert

While Original Medicare (Part A and Part B) doesn’t cover routine vision care, Medicare may cover emergency vision care or eye exams for qualifying beneficiaries.

If Medicare covers your vision care services, a Medicare Supplement (Medigap) plan can help pay for the out-of-pocket vision costs you may face, such as Medicare deductibles and copays.

Eye doctor talks with her patient in her office
Medicare may cover certain eye exams and emergency vision care.

Medicare Part A May Cover Inpatient Vision Care

Medicare Part A provides vision benefits only when you are admitted to a hospital as a result of some sort of emergency.

How Much Does Vision Care Cost With Medicare Part A?

Most people receive premium-free Medicare Part A, but there are other Part A costs you may have to pay for covered vision care.

In 2019, a $1,364 deductible is required for each benefit period, and then you may be responsible for paying coinsurance payments ranging from $341 to $682 for each day of an inpatient hospital stay.

Medicare Part B May Cover Some Eye Exams

Medicare Part B provides some limited vision care, but it won’t pay for routine eye exams or glasses and contact lenses.

Medicare Part B does, however, cover the following vision benefits:

  • Annual eye exams for beneficiaries suffering with diabetes

  • Annual glaucoma testing for those at high risk for the disease

  • Age-related macular degeneration diagnostic testing and treatment (for some)

  • Cataract surgery and associated corrective lenses

  • Prosthetic eyes

How Much Does Medicare Part B Pay for Vision Care?

Medicare Part B comes with a standard premium of $135.50 per month in 2019, but beneficiaries may pay more or less depending on their income and Social Security benefits.

After a $185 annual deductible is satisfied in 2019, Medicare Part B patients will typically pay 20% of the Medicare-approved amount for most covered services.

Some Medicare Part C (Medicare Advantage) Plans Cover Routine Vision Care  

Better known as Medicare Advantage, Medicare Part C is a collection of plans designed as an alternative to Original Medicare (Part A and Part B).

These plans must provide at least the same minimum coverage as Original Medicare, and some plans may include extra benefits, including vision benefits that cover routine eye exams and glasses

The cost of Medicare Advantage plan premiums, deductibles, copayments and coinsurance will vary by plan and insurer.

Medicare Part D Plans May Cover Some Eye Medications

Medicare Part D prescription drug plans may be used in combination with Original Medicare. These plans will vary in what types of drugs and medications may be covered, but some will often include eye medications.

Medicare Part D plan premiums, deductibles, copayments and coinsurance will differ from one plan to the next.

Medigap Plans Can Cover Out-of-Pocket Medicare Vision Costs

Medicare Supplement Insurance (Medigap) plan can help pay for some of the out-of-pocket costs associated with the vision benefits covered by Original Medicare. 

For example, each of the 10 standardized Medigap plans that are available in most states provide coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient vision treatments.

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

 

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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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