Does Medicare Cover Vision Care? 

According to the National Institute on Aging, human vision naturally changes with age. For many seniors, eyesight tends to get worse over time even if no genetic conditions or illness are involved. A decline of vision can come with a host of problems, including the inability to drive, recognize faces or read.

How to care for your vision

Because eyesight is so important for engagement in life, caring for your vision is crucial. Having a regular visit with an optometrist is often recommended for seniors to catch and correct declining vision and other eye problems before these issues begin to interfere with everyday activities.

If your optometrist detects a vision problem, there’s a good chance it can be addressed using corrective lenses like glasses or contacts. In some situations, eye medications or surgery may be necessary, but these are often a last resort. 

Does Medicare cover vision care?

Because seniors are one of the most affected demographics when it comes to vision problems, it’s a good idea to learn whether Medicare benefits offer vision care. It’s also worth looking into what costs are involved in vision care coverage if Medicare benefits apply toward vision care services.

Although Medicare benefits cover a wide range of medical services like visits with your primary care physician and diagnostic testing, the program does not cover routine vision care. Routine vision care, including eye exams, are not included in Original Medicare. However, Medicare may cover some vision care when it is related to injuries or illness. 

Medicare Part A covers some inpatient vision care

Medicare Part A provides full coverage for inpatient treatment once Medicare recipients have met their deductibles for the year. This means that if you are hospitalized or admitted to a skilled nursing facility, all of your care is covered for a limited amount of time each benefit period. If you require vision care as a medical necessity while admitted to an inpatient facility, this care will be covered by Medicare benefits through Part A in most cases.

Vision care coverage under Medicare Part B

Medicare Part B covers some aspects of vision care, although it does not cover routine eye exams, glasses or contacts. The Medicare benefits of Part B include coverage for medically necessary outpatient medical services, including things like doctor visits and outpatient surgeries. If you have a medical problem with your eye and see your doctor about it, this visit falls under the outpatient coverage of Medicare Part B.

Likewise, if you require ocular surgery to repair damage after an injury or to have cataracts removed, these services will also be covered by Medicare Part B. Medicare benefits do not, however, cover vision correction surgery like LASIK. In order for a surgical procedure to qualify for Medicare coverage, it must be deemed a medical necessity.

How Medicare Part D covers vision care

Medicare Part D supports vision health by covering prescription medications that can be used to treat diseases of the eye or to aid in recovery after an eye injury. For instance, if your eye is injured and you require antibiotics, either topical or oral, Medicare Part D may cover these medications as long as they are included in your plan’s formulary. This is a list of covered medications included with each Medicare Part D plan.

How Medicare applies to the cost of corrective lenses

As mentioned above, Original Medicare coverage does not apply to glasses and contacts. The only exception to this is if you have undergone certain eye surgeries that require you to wear corrective lenses for a period of time during recovery. In general, Medicare recipients can receive coverage for a pair of basic frames and lenses following procedures like cataract removal that involves the implantation of an intraocular lens.

How Medicare Advantage can help cover vision care

Medicare Advantage plans are required to include at least the same Part A and Part B benefits as Original Medicare, but most plans include additional benefits. Many plans include vision care coverage, with benefits for regular eye exams, glasses and contacts. Compare Medicare Advantage plans available in your area if you’d like to explore your options.