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Medicare and Dental

Medicare and Vision

As you age, so do your eyes. Regular vision exams are very important as you get older, especially if you are still driving/operating heavy machinery. In some cases, routine Medicare vision benefits may vary depending on what type of plan you have. Sometimes vision care is not covered at all. Always check with your insurance provider about which type of vision coverage you have before you decide to get a whole new vision plan.

Vision Benefits: What Are Your Options?

Medicare Part A: Medicare Part A does not cover your routine vision exams or eye refractions. Vision care is only covered when your vision is considered as a medical issue (traumatic injury or medical emergency – must go to the hospital).

Medicare Part B: Some of your vision care is covered by Medicare Part B, routine vision exams are not. Unless you receive cataract surgery, vision correction (eyeglasses/contact lenses) are not covered. Eye refractions are also not covered under Medicare Part B.

What services are covered by Medicare Part B vision?

  • Yearly glaucoma screening for people at high risk (You must pay 20% of Medicare coinsurance for vision care)
  • Cataract Surgery – covers cost of artificial lens as well as glasses with standard frames (You pay 20% of Medicare coinsurance for surgery)
  • Eye Prostheses – covers the cost for vision prosthesis replacement if vision is stolen, lost or damaged within first five years
  • Ocular Photodynamic Therapy with Verteporfin

Medicare Part C (Medicare Advantage): A handful of Medicare Advantage plans fully cover routine vision exams, vision correction products, and more.

Since Medicare Advantage plans have their own costs and additional coverage benefits, make sure to always compare plans before making a decision. Understand what services the plan covers, deductibles, exclusions, maximum coverage and more. Once you find a plan that you are interested in, explore the network providers. Usually if the network is larger, you may need to keep your current health care provider. Although, using network providers also means that you may have lower out-of-pocket costs.

Medicare Supplement Plans (Medigap): Supplement plans may help pay some of the costs that Original Medicare does not cover. The costs include copays, deductibles, and coinsurance for doctor visits, medical services or hospitalization. Discount programs are not included in Medicare Supplement plan benefits; however, they are additional options that may be offered to insured members.

Medicare Part D (Prescription Drugs): Since this plan offers prescription drug coverage, certain products related to vision care (eye drops/eye medication) may be prescribed by your optometrist

  • For more information on Medicare Part A and Medicare Part B, click here.
  • For more information on Medicare Advantage Plans (Part C), click here.
  • For more information on Medicare Supplement Plans (Medigap), click here.
  • For more on Medicare Prescription Drug Plans, click here.