Since so many conditions as well as the natural aging process cause many of us to need eye glasses or contact lenses, we just assume that Medicare must cover these things. People are shocked to find out that Medicare doesn’t cover vision care.
Why Doesn’t Medicare Cover Vision Care?
Back when Medicare was first created, insurance companies didn’t cover these types of things. Medicare followed what the insurance companies of the time were doing.
Because of this you do not find vision, hearing or dental services covered by Medicare.
In addition, the funding needed to cover these things means that congress is not likely to decide to change that any time soon.
If these services aren’t covered by Medicare, what are you supposed to do to pay for them?
Does Medicare Cover Any Vision Care?
Medicare does not cover routine vision service. This includes things like
- Eye exams
- Preventative care
- Or an exam for glasses.
However, Medicare does cover vision care when it becomes medically necessary. This means that Medicare covers things related to vision if it has to do with a disease or illness, just like it would with any other part of your body.
Macular degeneration, glaucoma and cataracts are just a few of the ailments that may affect the eyes and be covered by Medicare. You would visit a specialist for these just like you would any other disease or illness. Of course your Part B deductible still applies (which is $233 in 2022).
Once the deductible is paid, you would get the same 80% coverage under Part B that you would with any other medically necessary procedure. If you have a Medigap Plan, in many cases, you would even receive partial or full coverage of that other 20%. Keep in mind, supplement plans help with the other 20% only if and when Medicare approves and pays the initial 80%. If you have a Medicare Advantage plan you will often have vision coverage, where your eye exam is covered for $0, and you may get some coverage for glasses as well.
How to Pay for Vision When You Have Medicare
Since you will still need routine vision services that are not covered by Medicare, let’s take a look at the most common ways people find to pay for them.
Vision Insurance
The most common thing people do is just purchase additional vision insurance. Since, vision, dental and hearing are not covered by Medicare, there are many insurance options available that address just these needs.
A reputable insurance agent can help you find a good policy to cover the specific aspects you might need.
Medicare Advantage Plans & Vision Coverage
Some Medicare Advantage plans offer limited coverage for vision. Medicare Advantage is an alternative option to regular or original Medicare. The plans work a bit differently, but some of them include partial vision benefits as one of their ancillary benefits.
This can be really helpful, especially if you don’t have a ton of vision needs. However, beware, they are not guaranteed a full coverage option and each plan is different. Not all Advantage Plans offer vision coverage and what each plan covers changes every year.
Each Advantage plan is different and some options may offer only a small discount, while others may offer to cover an annual vision screening or even a pair of glasses. It is really important to make sure that you read and understand all of the details when dealing with Medicare Advantage plans.
Paying Out of Pocket for Vision Care
For some people this ends up being the only option and it isn’t always a bad one. You may find through shopping around that your local office offers their own discounts and many offer discounts to customers who pay in cash. If you are on a fixed income, you may want to consider looking for outside programs that may cover some services for you.
For people who have a health savings account, vision expenses do qualify as a medical expense. You can use health savings account funds for your vision care.
Vision Care Options with Medicare
If you want to know more about what your options are when it comes to paying for vision when you have Medicare, contact your local Medicare Insurance brokers and they can help you find the right option.
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